Background to this inspection
Updated
21 April 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The unannounced inspection took place on 25 and 26 February 2015.
The inspection was undertaken by one inspector. Before the inspection we reviewed information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law. We also reviewed information we had received from health and social care professionals and the local authority.
During the inspection we spoke with nine people who lived at Durnsford Lodge, three relatives, the registered manager and six members of staff. We also spoke with a visiting GP who supported many people within the home. We observed the care people received and pathway tracked four people who lived at the home. Pathway tracking is where we follow a person’s route through the service and capture information about how they receive care and treatment. We also looked around the premises and observed how staff interacted with people throughout the two days.
We looked at eight records related to people’s individual care needs and seven people’s records related to the administration of their medicines. We viewed six staff recruitment files, training records for all staff and records associated with the management of the service including quality assurance audits.
Following the inspection we contacted the local GP surgery for feedback regarding the quality of care at Durnsford Lodge.
Updated
21 April 2015
The inspection took place on 25 and 26 February 2015 and was unannounced.
Durnsford Lodge Residential Care Home provides care and accommodation for up to 28 older people who may also have mental health needs, including people living with dementia. On the day of the inspection 24 people were using the service.
The service had a registered manager in post. 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 the inspection people and staff were relaxed; the environment was clean and clutter free. There was a calm and pleasant atmosphere. Comments from people about the service included, “The staff show patience, compassion and humanity”; “There is good communication and kindness” ; and “The staff are lovely and very caring, I’m always made to feel welcome. It is one of the friendliest homes I visit, staff are always polite and friendly.” People moved freely around the home and enjoyed living in the home.
Care records were focused on giving people control and encouraging people to maintain their independence. Staff responded quickly to changes in people’s needs. People and those who mattered to them were involved in identifying their needs and how they would like to be supported. People’s preferences were sought and respected. One person told us “They do my nails, help me wash, I couldn’t ask for more.” People’s life histories, disabilities and abilities were taken into account, communicated and recorded, so staff provided consistent personalised care, treatment and support.
People’s risks were monitored and managed well. There was a culture of learning from mistakes and previous inspections to make care safer. Accidents and safeguarding concerns were managed promptly. Investigations were thorough and action was taken to address areas where improvements were needed. There were effective quality assurance systems in place. Incidents such as falls, were appropriately recorded and analysed.
People were encouraged to live active lives. Activities were meaningful and reflected people’s interests and individual hobbies. People enjoyed activities within the home such as bingo and excursions to local places of interest.
People had their medicines managed safely. People received their medicines as prescribed, received them on time, and understood what they were for. We spoke with the registered manager about ensuring people’s skin creams were recorded on their medicine charts. We found skin cream charts were not routinely completed to evidence people had received these as prescibed. People said “They help me with my medication, no problems. I needed an extra pain killer today and just asked.” People were supported to maintain good health through regular visits with healthcare professionals, such as GPs, physiotherapists and district nurses.
People, friends, relatives and staff were encouraged to be involved in meetings held at the home and helped drive continuous improvements such as the new outdoor space. Listening to feedback helped ensure positive progress was made in the delivery of care and support provided by the home.
People knew how to raise concerns and make complaints. People told us they did not have any current concerns but previous issues had been dealt with promptly and satisfactorily. Any complaints made were thoroughly investigated and recorded in line with Durnsford Lodge’s own policy.
People told us they felt safe. One person told us “Yes, I feel safe. Everything is done for safety, there are call bells if you fall or need help and doors are locked to keep unwanted people out.” Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by staff. All staff had undertaken training on safeguarding adults from abuse; they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
Recruitment chacks were undertaken and staff received a comprehensive induction programme. There were sufficient staff to meet people’s needs. Staff were kind, caring and thoughtful. Staff were appropriately trained and had the correct skills to carry out their roles effectively. One staff member said “I absolutely love it here; I love making the residents smile, I love them all – fantastic place to work, more like a home, a big family. We treat people how we would treat our own family members, with love and care.”
Staff described the management as open, supportive and approachable. Staff talked positively about their jobs. Comments included, “It makes me feel proud to work here, that I can do something to help. Dancing, singing, it brings people joy. I have a good rapport with families and health professionals.” Other staff said “Not a lot could be better. I love working here. I have made new friends and love the residents and families”; “I really like my job; I like helping people, the stories they tell me, the bond we make together. They fought in the war for us so they deserve the best.”