Dove Court Care Home

Dove Court Care Home is a residential care home providing personal and nursing care for up to 120 people across four separate 30 bed purpose-built houses, each of which has separate facilities. One of the houses specialises in providing care to people with complex dementia nursing needs. At the time of our inspection there were 108 people using this service.

People’s experience of using this service and what we found

Medicines were not always administered and managed safely, and staff recruitment systems required some improvements, we made a recommendation about this. People’s views on staffing levels were mixed and risk assessments were not always in place to identify people’s specific health conditions. Staff had received safeguarding training and people felt safe living at the service. Infection control procedures were followed.

Care plans and risk assessments had not always been updated to reflect people’s current needs. Further improvements could be made to the environment to support people living with dementia. However, the service was clean, well decorated and well furnished. Staff had received appropriate training for their role. People’s nutritional needs were being met and referrals to health care professionals were being made.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated well and supported by staff who knew them. We witnessed positive interactions between staff and people living at the service. Staff members spoke positively of the work they do and felt they had time to sit and talk to people. People’s rights to confidentiality were respected.

Feedback on activities was mixed and we made a recommendation about this. Some care plans lacked detail to guide staff whereas others showed detailed information on people’s preferences and life history. The registered manager had identified these issues and was in the process of rectifying this. People’s communication needs were identified and there was a system in place for managing and responding to complaints.

Audits were not always effective in monitoring the safety of medicines, we made a recommendation about this. Policies and procedures were in place to guide staff. We observed staff and senior management to be pleasant and accommodating and staff spoke positively of the registered manager. People’s views were actively sought through meetings and satisfaction surveys.

For more details, please see the full report for Dove Court Care Home which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 13 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified a breach in relation to medicines. We have made recommendations in relation to staff recruitment, activities, and governance systems.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection on November 2015 we found there were no breaches of legal requirements.

Dove Court Care Home is a care home that provides nursing care. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Dove Court Care Home is purpose built and accommodates 120 people across four separate 30 bed houses, each of which have separate spacious communal areas, suitably equipped bathrooms and a satellite kitchen. Each house has a unit manager. The houses comprise of Robin for people with general nursing needs, Nightingale for people who require personal care and support, Swallow provides personal care and support for people living with dementia and Kingfisher provides nursing care for people who are living with dementia. There were 114 people accommodated in the home on the day of our inspection.

At the time of our inspection the registered manager was no longer managing the service. A manager had been in post from 18 September 2017; an application to register with the Care Quality Commission (CQC) had been forwarded. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection we found that all regulations were being met.

People told us they felt safe and staff were caring. Staff were observed to have positive relationships with people. There were no restrictions placed on visiting times for friends and relatives. We observed staff communicating with people in a kind and respectful way. People told us staff respected their privacy and dignity and encouraged them to be independent.

Safeguarding adults' procedures were in place and staff understood how to protect people from abuse. People were complimentary of the staff who supported them and felt they had the knowledge and skills to meet their needs. They described staff as ‘friendly’, ‘brilliant’, ‘caring’ and ‘thoughtful’.

People’s views with regards to staffing levels varied. Some considered there were enough suitably skilled staff to support them when they needed any help whilst others felt this could be improved at times. Staff generally felt they were suitable numbers of staff available and that staffing levels had improved recently under the new manager. We noted a shortfall in staffing during the inspection which was addressed immediately. Staffing levels were monitored to ensure sufficient staff were available and the recruitment of new staff was underway.

A robust recruitment procedure was followed to ensure new staff were suitable to care for vulnerable people. Arrangements were in place to make sure staff were trained and competent.

Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained and supervised to do this safely.

People opinions about the standard of the meals varied. People were offered choices and alternatives to the menu were provided. Improvements regarding how people’s meal time experience could be improved were shared with the manager.

People were supported to take part in a wide range of suitable activities which were held on each of the houses.

The information in people’s care plans was sufficiently detailed to reflect that people were at the centre of their care. We noted a number of gaps were evident in some of the personal care records; they were being addressed. People’s care and support was kept under review and, where appropriate, they were involved in decisions about their care. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.

People had choice and control over their lives and staff supported them to be independent in the least restrictive way possible. People's capacity to make their own decisions had been assessed and recorded in line with the requirements of the Mental Capacity Act 2005 and appropriate Deprivation of Liberty Safeguard (DOLS) applications had been made to the local authority.

The home was clean, bright and comfortable and appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. Some people had arranged their bedrooms as they wished and had brought personal possessions with them to maintain the homeliness. Further improvements needed consideration to ensure the home was suited to the needs of people living with a dementia.

People’s feedback about the service was sought with good evidence they were listened to. Appropriate and prompt action had been taken to respond to people’s concerns and suggestions.

People told us the home was well managed. There were effective systems in place to monitor the quality of the service to ensure people received a good service. The manager had identified areas for improvement and appropriate action was currently being taken to address any shortfalls.