The inspection took place on 30 November and 3 December 2015 and was unannounced. This meant the provider or staff did not know about our inspection visit.
We previously inspected Dipton Manor Care Home on 16 September 2013, at which time the service was compliant with all regulatory standards.
Dipton Manor Care Home is a residential home in Dipton providing accommodation and nursing care for up to 71 older people who require nursing and personal care. There were 68 people using the service at the time of our inspection.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We found that there were sufficient numbers of staff on duty in order to meet the needs of people using the service and call bells were answered promptly.
We saw that individual risks were managed through risk assessments and associated care plans in each person’s care file. These risks were reviewed each month. We observed behaviours that could be perceived as challenging supported sensitively.
We found the service had systems in place for ordering, receiving, storing and disposing of medicines. We looked at how the service managed controlled medicines and found that safe storage, administration and recording was maintained.
Safeguarding information such as types of abuse to be mindful of and contact telephone numbers were prominently on display and staff displayed a good knowledge of safeguarding issues.
There were effective pre-employment checks of staff in place and we saw the disciplinary policy was adhered to when a potential safeguarding concern was raised recently.
The service was clean throughout, with a range of infection control measures in place and working effectively.
Staff completed training to meet people’s individual needs in areas such as: catheter care, dementia awareness and PEG feeding (PEG feeding is a way to care for someone who can’t have foods orally). This was in addition to training the provider considered mandatory, such as safeguarding, health and safety, moving and handling, dignity and respect, food hygiene and infection control. When we questioned staff about the practicalities of a range of these areas, they were able to give detailed and informed answers.
Staff also had a good knowledge of people’s likes, dislikes and life histories.
Staff were well supported through formal supervision and appraisal processes as well as ad hoc support when required.
Meals were varied, prepared by kitchen staff passionate about their work and people told us they enjoyed the food. People had choices at each meal as well as being offered alternatives if they did not want the planned meal options. We saw the service had successfully implemented a tool to manage the risk of malnutrition and people requiring specialised diets were supported.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).
We checked whether the service was working within the principles of the MCA. We found related assessments and decisions had been properly taken and the provider had followed the requirements in the DoLS.
We observed a range of dignified and thoughtful interactions during our inspection, with people who used the service and staff sharing jokes; the atmosphere was welcoming and homely. Relatives and external stakeholders unanimously agreed that the service was caring and we saw people’s rights were respected and upheld.
Person-centred care plans were in place and daily notes were comprehensive. Regular reviews ensured relatives and healthcare professionals were involved in ensuring people’s medical, personal, social and nutritional needs were met.
The service had four activity co-ordinators who facilitated a range of group and individual activities. We saw some of these activities during our inspection and evidence that activities were planned on the basis of suggestions made at resident and relative meetings, as well as the ongoing programme of optional group activities.
People’s religious beliefs were respected and encouraged through liaison with the local church and a flexible approach to person-centred care provision.
Staff confirmed they were well supported to pursue their own career progression. All people using the service we spoke with, relatives, staff and external professionals were complimentary about the approachability of the registered manager. Strong community links had been made to ensure the service was part of the community and that people who used the service were able to remain part of their community.