Dalling House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Systems and processes were in place to assess and review people’s needs, however, these were not always effectively followed. For example, one person had been re-admitted to the home without having an up-to-date assessment. Care plans had not been regularly reviewed, and people and their relatives told us they were not always routinely involved in reviews. Whilst we observed staff asking people for their consent before providing care, this was not always robustly documented. People had been supported to access advocacy services where needed. Staff knew people well and delivered care in line with their needs, however improvements were required to the documentation and review of this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us that they were not always fully involved in assessments and reviews of care. One relative told us, “Not been to a review meeting. Been trying to arrange one, about 6 months ago but it’s still not happened”. Another added, “Not involved in the initial assessment or ever been asked to any reviews of care”. Some relatives commented that they had been involved in reviews, but these were not often. This feedback was shared with the provider and registered manager so improvements could be made.

Staff knew people well; however, care plans and assessments were not always up to date to robustly guide their practice. The registered manager was able to describe the assessment process for when a person was admitted to the home, however, this had not always been followed. Staff told us they would regularly speak to people to ascertain any changes in their needs and wishes, however, this was not always documented in care records.

There were systems and processes in place to assess people’s needs before they moved into the home, and for reviews to continue whilst a person lived at the home. However, this was not always robustly followed. One person had not been robustly assessed before being re-admitted to the home. A number of care plans we reviewed had not been reviewed since March 2024 or before. There had been a gap in managerial cover over this period, but no effective mitigation had been implemented to ensure continued assessment and review of care plans.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were not able to give a clear indication of whether they were asked for consent or were able to do what they wanted when they wished. However, our observations showed staff treating people with kindness and reassurance. Relatives did not express any concerns regarding their loved ones being asked for consent. Documentation and daily notes regarding consent were lacking details.

Staff were observed to give people choices throughout the day. People were asked for their consent before care was given. However, there were gaps in documentation and practices regarding this. For example, we saw some people being given a podiatry treatment in the communal area. There was no attempt to promote privacy. The provider advised that people had consented to this however, there was no documentation about these discussions. The provider was taking action to address this. Where needed, staff had supported people to access advocacy.

Processes were in place to assess and monitor people’s capacity in relation to consent. The documentation of this was not always robust. For example, one care plan stated a person did not have capacity to manage their medicines however there was not specific mental capacity assessment or risk assessment in relation to this. This had also not been reviewed since 2023. Whilst we did not see any evidence of negative impact on people in relation to this, it was highlighted to the provider and registered manager as an area which required improvement. Where necessary, people had deprivation of liberty safeguards (DoLS) in place, which were monitored by the registered manager.