The Care Quality Commission
  • Care Home
  • Care home

Archived: Davey Court

Buckingham Close, Douglas Avenue, Exmouth, Devon, EX8 2JB (01395) 273860

Provided and run by:
Devon County Council

All Inspections

9 October 2014

During an inspection looking at part of the service

The questions we asked on this visit were:

Is the service safe?

Is the service caring?

Is the service effective?

Is the service responsive?

This is a summary of what we found.

This was a follow up inspection to look at required improvements which had been made in relation to care and welfare and records management, following our previous inspection in August 2014. Following the inspection the provider sent an action plan to the Care Quality Commission (CQC) detailing the improvements being made.

We found improvements had been made and people were having their care and treatment planned and delivered in a way that ensured their safety and welfare. We found the care records for people receiving respite support and care at the home were accurate and fit for purpose. These areas are now compliant.

One inspector visited the home and spent approximately four hours there. At the time of the inspection there were 13 people who were living at Davey Court and two people who were receiving short term respite support at the home.

As part of our inspection we looked at the care files of two people who were receiving respite support at the home. We spoke with the registered manager, two deputy manager's, a supporting manager from one of the providers other homes and three care workers.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the service was safe. This was because people staying at the home for short term respite support had their care and welfare protected. We saw assessments to identify risks had been completed accurately and support plans reflected the risks which had been identified.

Is the service caring?

We saw the service was caring, staff provided care and support in a kind and respectful way. For example we saw care workers sat interacting in a kindly manner with people in the main communal lounge. We also observed a person being supported in the main corridor by the registered manager and care workers. The person was treated respectfully in a calm way and was not rushed.

Is the service effective?

We found the service was effective because the staff had consistently planned care and support for people receiving respite support at the home. We spoke with two relief care workers about the needs of people receiving respite support at the home. They told us they had received a handover and were able to tell us the needs of the people they had supported.

Is the service responsive?

The service was responsive for the health care needs of people living at the home. The home used a handover sheet which was regularly updated to inform care workers about changes made to people's care and support needs and therefore they were able to be responsive to them.

11 August 2014

During an inspection in response to concerns

The questions we asked on this visit were:

Is the service safe?

Is the service caring?

Is the service effective?

Is the service responsive?

This is a summary of what we found.

This was a responsive inspection following a notification from the service regarding a serious incident which had occurred at the home.

One inspector visited the home and spent approximately five hours there. Owing to the concerns raised we wanted to ensure the home provided support to people in order to meet their care and welfare needs.

At the time of the inspection there were 14 people who were living at Davey Court and five people who were receiving short term respite support at the home.

As part of our inspection we spoke with the registered manager, the deputy manager, the provider's resource manager and seven care workers along with a visiting district nurse who regularly visits the home.

Following the inspection the registered manager submitted an action plan to the Care Quality Commission (CQC) which told us what actions they had put into place to rectify the concerns found. This included a more robust system to ensure people's risk assessments were completed accurately and care workers would be given clearer information about new people coming into the home.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the service was not always safe. This was because people staying at the home for short term respite support did not have their care and welfare protected in the same way as people who were permanently living at the home. We saw assessments to identify risks had not been completed accurately, care plans did not always reflect risks which had been identified.

Is the service caring?

We saw the service was caring, staff provided care and support in a kind and respectful way. For example we saw care workers were supporting people and were kind and discreet in their approach. We saw there was a pleasant atmosphere, people appeared happy and were interacting happily with the care workers.

Is the service effective?

We found the service was not effective because the staff had not consistently planned care and support for people receiving respite support at the home. We spoke with care workers about the needs of people receiving respite support at the home. Their responses on how to provide care for people was often different and did not reflect the information in people's care folders. This meant people were receiving care and support which may not be relevant to their needs.

Is the service responsive?

The service was not responsive for the health care needs of people receiving respite support.

We found staff were not always informed of changes made to people's care and support needs and therefore were unable to be responsive to them.

However a visiting district nurse told us their team were contacted quickly if there were any concerns about their patients and they were happy the home followed their guidance.

15 July 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

The service was safe because people who live at the home told us they were well looked after and were happy. One person we spoke with said "I really like it here; I am very well looked after". Another person confirmed that living at the home was "Grand, I enjoy my life here". Another person told us 'I am very well looked after and I am sure everyone else is as well".

People had been protected against the risks associated with medicines because the provider had appropriate arrangements in place to safely manage medicines.

Recruitment practice was safe and thorough.

Policies and procedures were in place to make sure that unsafe practice had been identified and people were protected. Systems were in place to make sure that the manager and care staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The Care Quality Commission [CQC] monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, policies and procedures were in place. Relevant senior staffstaff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

The service is effective because we found that people's consent had been obtained for care and treatment provided to them by the service. However this had not been consistently recorded when people had received treatment or when care plans had been reviewed.

People's health and care needs had been assessed with them or their representative and had been involved in writing their plans of care. If people had been assesses as not having the ability to be involved a best interest decision would be made by the persons representatives..

Is the service caring?

The service is caring. We spoke with nine people who live at Davey Court. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example; 'They all work so hard" and 'They have great patience and are all kind and friendly'

When speaking with and observing care staff during this inspection it was clear they genuinely cared for the people they supported. They told us about people's individual health and social care needs and how these needs had been met in an individual way.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The service is responsive..We spoke with nine people who live at Davey Court. We saw from records that planned care and treatment had been provided in line with people's individual care plans. Aspects of people's needs or care had been linked to risk assessments. Specialist health needs had been identified where required and appropriate health care professionals had been consulted and involved in providing care.

Is the service well-led?

The service is well led. The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

People who live at the home, all staff and family members had been asked to complete a satisfaction survey in July 2013. The deputy manager told us where shortfalls or concerns were raised these would be taken on board and responded to appropriately.

22 November 2013

During a routine inspection

We, the Care Quality Commission (CQC) spoke with eight people who lived at the home, spoke with seven staff, the manager, two visiting district nurses and one relative. We also spent time observing the care people received as many people had a dementia type illnesses and were unable to verbally communicate with us.

People were treated with respect. Staff sat with people, talked with them and were kind. One person said "The staff are lovely". People were offered choices of food and drink and asked if they liked the food and drink that they were given. Staff were empathetic towards people and took time to listen and determine how people felt based on their body language. Staff regularly walked around the home and asked each person how they were. People told us that they felt safe.

We found that there were satisfactory numbers of staff on duty to meet people's needs. Staff were well supported and had completed or were about to attend appropriate training. They knew people as individuals and were aware of each person's needs. The service had good relations with health care professionals and acted upon their advice.

The home warm, clean and the atmosphere was relaxed and friendly.

Records were kept securely. However not all were up to date.

29 January 2013

During a routine inspection

There where twenty four people at the home. The manager explained the home had a reduced occupancy as the provider has plans to develop the property, currently only admitting people for respite.

Staff levels had not been reduced, staff taking the opportunity to update training and spend extra time with the people, producing scrap books aiding people to reminisce, and develop other activities for people enjoy. Staff we spoke to where excited about the changes.

Dates for the alterations had not been confirmed. The manager assured us that families have been informed how the alterations will be managed. The provider will inform CQC regarding the plans once dates are confirmed.

People using the service had been advised of the changes and receive updates and newsletters.

We walked around the building, despite the impending plans, both occupied and unoccupied rooms where clean tidy and maintained. Communal and storage areas were clean tidy and maintained, we observed staff cleaning rooms and corridors. The current environment was not compromised.

We observed staff facilitating activities and interacting with the people. We spoke to five people, receiving very positive comments. People told us that 'they liked it where very comfortable and enjoyed the meals. Cannot fault it, like all the staff'.

The staff team and families take an active role, holding events such as raffles, sponsored bike rides raising funds to provide entertainment and events.

2 March 2012

During an inspection in response to concerns

We last visited Davey Court on 28 July 2011 to check on the actions the service had taken to address compliance actions made on 8 March 2011. We found in July 2011 that there had been significant improvements and that people living at the home were well cared for.

At the end of February 2012, we received information that raised concerns about the care of people living at the home and restrictions on visiting. These concerns related to late 2011. We visited the home on 2 March 2012. This inspection was unannounced and took place over approximately six hours. We were told by staff that there were 34 people living at the home.

During our visit, we spent time with people living in the home, either in communal areas or by visiting people in their bedrooms. 12 people were able to share their views about their care with us. However, other people were unable to comment directly on their experience so to help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. We spent the majority of our time with the people living at Davey Court but we also spoke with six staff members, visited people's bedrooms and looked at care records.

We saw that people living at the home were at ease with staff and with one another. We saw that some people had formed close friendships and these were respected by staff, as were the relationships of couples living at the home.

We met two people, who told us they preferred to spend time in their room, which included eating their meals in their bedrooms. They had differing reasons for this decision but both told us that staff respected their choices and responded quickly if they used their call bell.

We saw that people were supported with moving around the home in a dignified manner. Throughout our visit, we saw that staff treated people as individuals by varying their approach and support to suit the person's needs and character.

We spoke with people who had recently moved to the home, and one person told us about their visitors and how they were made welcome. Whilst we were inspecting the home, we met someone who had just moved in and later we saw them being visited by their family.

Five people told us how they were happy with the way staff treated them and gave us examples, such as supporting them with bathing in a way that did not embarrass them. One person said 'They're lovely here. You'll have a laugh here' and another person told us 'I've really enjoyed myself this week'. A third person said 'I'll think you'll find we're well treated here'. A fourth person told us 'If I'm cosy, I'm contented'; we saw they had a blanket over their knees, slippers on and that staff regularly checked they were comfortable. A fifth person said that people were 'treated well here' and a sixth person said it was 'very restful'. Their opinions were confirmed by our observations of the interactions between staff and people living at Davey Court, which showed that people felt at ease and able to move freely around the home.

People commented to each other about the food; all of these comments were positive. People said 'I enjoyed that', 'Wasn't that nice?', and 'That was really nice'. One person said to staff member 'I'll eat anything as long as someone else cooks it!' One person told us that they enjoyed not having to worry about cooking and another told us 'the food is good here'. However, staff also recognised that one person saw their role to care for others so involved them in laying the tables and confirming the arrangements for lunch. In our discussions with staff, they explained that this was important to the person's sense of identity and self-worth.

Two people told us how they were offered a choice of meal and explained what would be available if they did not like the choice. They showed us the menu for the day and told us they were happy with the quality of the food.Staff gently prompted people and offered help discreetly, such as offering to cut up food. People were given cutlery that suited their needs and people were not discouraged from eating in their preferred manner.

28 July 2011

During an inspection looking at part of the service

We carried out a planned unannounced inspection on 8 March 2011 at Davey Court when we made compliance actions for the home to complete in order to achieve compliance with the Health and Social Care Act 2008.

We carried out this responsive unannounced review on 28 July 2011 to check on the compliance actions that we had made after the previous inspection. Devon County Council has kept us up to date with their revised improvement plans, which demonstrated how they have addressed the concerns from our visit in March 2011. The registered manager was present on the day of the inspection.

Our visit took place over approximately eight hours. We spoke with ten people living at the home, and five staff members. During our visit, we completed a SOFI 2 observation, which helped us to make judgements about people's well-being, and how staff interacted with them. We used this because some people were unable to make direct comments about their care.

We met with people either in their rooms or in communal areas. We spent time in communal areas, which enabled us to observe people's care and hear conversations between staff and people living at the home.

We used pathway tracking to see how three people's care and social needs were met. Where possible, we met with the person. We looked at their care records and spoke to staff about how they met their care needs. We spoke to staff about staffing levels and carried out a tour of the building to check on the cleanliness.

When we visited the home on 28 July 2011, we were told there were 34 people were living at the home and there were nine vacancies. We were told that since our last visit nobody had moved to the home on a permanent basis or on a respite stay, which was a decision made by the provider. We were told that there was nobody living at the home with a pressure sore and no one receiving end of life care. However, we were told that referrals had been made for several people to be assessed for nursing care because of an increase in their care needs.

8 March 2011

During an inspection in response to concerns

We saw a mixed approach by staff in the way they involved people and respected their dignity. Some staff that we saw working with people showed through their actions, in their conversations and in their discussions with us, empathy towards the people they cared for. However, we saw another member of staff supporting someone with their meal, with minimal interaction, not taking time to tell them what they were eating, which included a change from a cooked meal to a pudding. We also observed some staff making decisions for people without consulting them.

Generally, people seemed relaxed with staff and their surroundings. We saw a small group of people reminiscing with staff using the 'Daily Sparkle', a newspaper which had been bought by the home to initiate discussion.

We saw from residents' meetings minutes that people had been asked about what they liked to do, and we heard from the manager how these were being implemented. During the day, we saw that people went out with individual members of staff for walks, and one person who told us they loved the garden spent some time outside.

We saw that one person was restless, which was recognised by a staff member from the housekeeping team, who took them to choose some bread from the kitchen downstairs which they responded well to. We saw from people's records that they have access to a range of activities, including exercise and skittles.

However, we found that for some people a lack of stimulation meant that they slept or watched each other or staff. This was partly influenced by which lounge they sat in. We were at the home for seven hours and some people spent substantial periods of time asleep. Some staff were more observant than others, so they checked to see if people were warm or needed assistance but others lacked this level of attention.

When we arrived in the building, there was an unpleasant odour on the upper floor of the building; there were also pockets of odour, which smelt like urine, in areas of the lounges and in the corridors. We visited nine bedrooms, and saw that three armchairs were unclean with stains. We returned to the home on the following day to return an item from the home, and we noted that the reception area of the home smelt strongly of urine.

Many people that we met were not able to comment specifically on the staffing levels and staff skills at the home but we observed that some staff were more attentive than others and took time to make eye contact and listen to the person they were supporting.

We saw some people living at the home sharing a joke with staff, and appearing relaxed and at ease with them. However, there were times that staff behaviour was not person centred, such as talking over people, which was an example of poor practice.