Archived: Darlington Manor Care Home

About the service

Darlington Manor Care Home provides residential care for up to 60 older people. At the time of inspection 32 people were living at the home, some of whom were living with dementia. Accommodation was spread over two floors, each with their own adapted facilities.

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

At the last inspection we recommended the provider undertake a review of the risks to people’s health to ensure care records reflected those risks and, ensured medicines management followed national guidance.

At this inspection we found improvements had been made. The registered manager and provider had implemented all of the recommended actions from their last inspection and had improved how they monitored the quality of the service people received.

People and their relatives told us they felt safe and staff were supporting them well. One person told us, “Staff are marvellous!”

People's care and support needs were assessed. Records reflected people’s current needs. Medicines were managed safely. Close links with other professionals had been implemented to ensure people's physical and mental health needs were continually met with changes responded to quickly.

The home had a dedicated infection prevention and control champion who ensured national guidance was being followed. The registered manager monitored all areas of the home. This ensured high standards of infection prevention and control were delivered and that suitable supplies of personal protective equipment was available. Additional activities had been planned within the home to positively support people. People were supported to keep in touch with their relatives by telephone and video calls. The provider and staff communicated regularly with family members about the latest guidance and to update on their relative’s health.

Staff understood how to safeguard people from abuse. People's privacy and dignity was seen to be maintained. The staff team had the necessary skills to support people appropriately. Enough staff were on duty to respond to people's needs in a timely manner. No agency staff were working in the home. The registered manager used information from accidents and incidents to learn lessons. Staff were recruited safely.

The service was well led. The management team were praised by people, their relatives and staff, for their supportive approach. Systems were in place to monitor the quality of care provided and to continuously improve the service. The management team and staff worked extremely closely with health professionals to achieve positive outcomes for people’s health and well-being.

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

Rating at last inspection

The last rating for this service was requires improvement (published 7 December 2019). Two recommendations were made.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and had made the necessary improvements to meet the recommendations. This report only covers our findings in relation to the key questions safe and well-led.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Darlington Manor Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

People and their relatives told us they were happy with the care and support they received at the home.

Systems were in place to ensure medicines were managed safely. People told us they received their medicines on time. However national guidance was not always being followed to record and ensure people received their medicines safely. We have made a recommendation the provider reviews their medication management systems.

Risks to people’s health were assessed to ensure staff had guidance on how to keep people safe. However, some information recorded was limited and care records did not always reflect people’s current needs. We have made a recommendation the provider undertakes a review of all people’s care plans and risk assessments.

Staff knew how they would identify any signs of abuse to ensure people were kept safe. Most people told us there was enough staff on duty to meet needs.

Recruitment systems were in place; however, some records did not show where gaps on people’s employment history had been checked.

People were supported with their eating and drinking, and care plans were in place which included their preferences and any specialist dietary needs. However, where people were at risk of losing weight additional monitoring records were not always being implemented.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and procedures in the service should have supported this practice. However, records were not always clear to show where staff were providing support in people’s best interests. We have made a recommendation the provider reviews their systems to strengthen this area.

Care plans contained some person-centred information and despite not always being up to date, staff were able to tell us people’s current needs and preferences. People’s social needs were met. There was an activities programme in place.

The provider’s quality assurance checks had not been effective in identifying the issues found during the inspection.

Checks were carried out to make sure the building and equipment were safe. The home had been redecorated and refurbished and met people’s needs.

There was a positive atmosphere at the home, staff told us they enjoyed working there and felt valued by the registered manager and provider. We observed this positivity was reflected in the care and support which staff provided.

Staffing levels were monitored by the registered manager to ensure there was enough staff deployed to meet people’s needs. Staff received regular supervision, an annual appraisal and, training in line with the provider’s policy.

The service worked closely with other professionals and agencies to meet people’s needs. A complaints system was in place. Lessons were learnt from adverse incidents.

For more details, please see the full report 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 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Darlington Manor is a residential care home based in Darlington, County Durham. The home provides personal care for older people and people with dementia. It is situated close to the local park, amenities and transport links. On the day of our inspection there were 46 people using the service.

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 last inspected the service in February 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

The atmosphere of the service was homely and relatives told us it was was very welcoming. People who used the service and their relatives that we spoke with told us they felt the service had a family approach.

Without exception we saw staff interacting with people in a person centred and caring way. We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness. We saw staff being considerate and communicating with people well.

We saw that people were encouraged to enhance their wellbeing on a daily basis to take part in activities that encouraged and maximised their independence and also contributed positively to the homely atmosphere.

We spoke with a range of different team members; care, kitchen staff, activity staff, domestics and maintenance staff who told us they all felt well supported and that the registered manager was supportive, and they were all polite, receptive, open and approachable. We also spoke with visiting professionals from the community nursing team.

Throughout the day we saw that people who used the service, relatives and staff were comfortable, relaxed and had an extremely positive rapport with the registered manager and also with each other.

From looking at people’s care plans we saw they were written in plain English and in a person centred way and they also included a ‘one page profile’ that made use of, personal history and described individuals care, treatment and support needs. These were regularly reviewed and included family members and people in the process.

Care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care plans we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP, community nurse or optician.

Our observations during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes in a person centred way.

When we looked at the staff training records, they showed us staff were supported and able to maintain and develop their skills through training and development opportunities were accessible at this service. The staff we spoke with confirmed they attended a range of valuable learning opportunities. They told us they had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs. We also viewed records that showed us there were robust recruitment processes in place.

We observed how the service administered medicines and how they did this safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicine and we found that the medicine administering process was safe.

People were actively encouraged to participate in numerous activities that were well thought out, organised, personalised and meaningful to them including regular entertainers. We saw staff spending their time positively engaging with people as a group and on a one to one basis in fun and meaningful activities. We saw evidence that people were supported to go out regularly too.

We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a varied selection of drinks and snacks. The daily menu that we saw was reflective of people’s likes and dislikes and offered varied choices and it was not an issue if people wanted something different.

We saw a complaints and compliments procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. The compliments that we looked at were complimentary to the care staff, management and the service as a whole. People also had their rights respected and access to advocacy services if needed.

We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views about the care and service they received at meetings and via surveys.

The service undertook regular questionnaires not only with people who lived at the home and their family but also with doctors and visiting professionals. Some of the comments included; 'Very friendly and staff are well informed' and 'I like how staff interact with clients, it's respectful and friendly'. We also saw a regular programme of staff and resident meetings where issues where shared and raised. This showed the service listened to the views of people.

The home provided care specifically for people with dementia in one area of the home and both the manager and senior care staff agreed with the fact the environment could be adapted to cater more specifically for the needs of people with dementia.

We found that medication was stored and administered correctly and the home also followed policies for the safe recruitment of staff.

People were positive in their views about the home. They told us;

'Its lovely here, all the girls are good, they are all different but all are very kind' and

'If you have any complaints about anything you can tell them".

We had lunch in one of the dining rooms and saw staff spend time with people and supported them with dignity and respect. There were sufficient staff on duty to support people for their care needs. We saw that there was a training and supervision programme in place for all staff and records showed that staff were able to raise any issues in their supervision session that were addressed by the home. One staff told us; 'Sometimes its challenging but I really enjoy it. The seniors are really supportive and the service has helped me work around my family commitments'.

We spoke with relatives and visitors to the home who were very positive in their comments about the home and about the care their relatives received. One person told us; 'I can't praise the staff highly enough'.

We saw the provider had a quality monitoring processes in place to check the quality of the service, which included the views of people and their relatives.