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Reports


Inspection carried out on 12 - 13 December 2017 and 21 December 2017

During a routine inspection

We rated The Dallingtons as good because:

  • The service had good medications management in place. Resuscitation equipment and emergency drugs were available. Staff checked these regularly.
  • The wards were clean, had appropriate furnishings and equipment, and were well maintained by staff.
  • Shifts were consistently covered with a sufficient number of staff.
  • Staff used restraint as a last resort. There was emphasis upon verbal de-escalation and using non-physical techniques to calm patients who were distressed.
  • All staff knew what constituted an incident and knew the reporting system in place. Managers ensured that staff received feedback and learning from incidents.
  • All patients had a physical examination upon admission. Physical healthcare monitoring was undertaken routinely. Patients had care plans in place to reflect physical illness.
  • Staff received supervision in line with the provider’s policy.
  • Staff adhered to consent to treatment and capacity requirements.
  • Where possible, staff encouraged patients and relatives, to be involved in their care and treatment.
  • Staff responded to complaints appropriately, and within a timely way. An apology was given if necessary.
  • All staff knew the senior management team, who were visible and approachable.
  • Morale among the staff was good across both wards. Staff genuinely enjoyed their roles at the hospital.

However,

  • There had been one occasion when the provider failed to notify the CQC of a safeguarding concern in a timely way.
  • Only 67% of staff had received training in manual handling.
  • Not all care plans were evaluated in detail.
  • Appraisals undertaken did not detail discussions around personal development and future goals.

Inspection carried out on 22-24 March 2016

During a routine inspection

Overall we rated The Dallingtons as requires improvement because:

  • There were empty medication containers showing patient’s confidential information, disposed of in the general waste bins. This meant there was a risk that confidential information could be accessed by a member of the public.
  • There were seven errors relating to the prescribing of medication. These included occasions where the maximum dose had been exceeded and the wrong category of medication had been prescribed.
  • There was no on call medical cover rota, and there was an expectation for doctors to be available 24 hours a day.
  • There were no emergency medications available if, for example, the patient was having a severe allergic reaction or cardiac arrest.
  • Twenty percent of staff had not received supervision within the past two months in line with the provider’s standard.
  • Forty-nine percent of staff had not received an annual appraisal within the past twelve months.
  • The registered manager told us that no nationally recognised outcome tools were being used to assess the effect of the care and treatment provided to patients

However:

  • The environment was clean and tidy, in a good state of repair, suitable for care and treatment, and was risk assessed.
  • Robust systems enabled staff to report incidents.
  • Patients’ needs were assessed, and care and treatment was planned to meet identified needs.
  • Patients received regular one to one time with their named nurse and there was evidence of this in the care records.
  • Staff appeared kind with caring and compassionate attitudes, and engaged with patients in a kind and respectful manner.
  • Activities were available for patients’ specific needs, including local walks, music group, cooking, bingo, pool, arts and crafts, and a money matters group.
  • The automated external defibrillator (AED), a machine used when a patient is in cardiac arrest, was checked weekly

Inspection carried out on 27, 28 February 2014

During a routine inspection

The Dallingtons had two units, ‘The Lodge’, which provided care for male patients and ‘The House’, which provided care for female patients. We visited ‘The Lodge’ and spoke with nine out of 19 patients. We also spoke to the registered manager and several staff who were supporting them and we observed how support was provided.

Patients told us that they were involved with the care, treatment and support they received from staff. They said they had the choice to get involved with activities in the unit and outside in the community. For example this included having one to one and group sessions such as, meal planning, baking, keep fit, board games, anger management, art and craft and health promotion. One person said, “I clean my room and do cooking lessons, and I enjoy this”. They also said, “The food is nice and this place is better than the last hospital I was staying at”. Another person told us, “They tell me my rights, I take my medication and consent to this” and “The staff tell me I am doing well in my review meetings”.

The registered manager had a complaints system and responded to complaints in a timely way. Patients told us that they knew how to make a complaint if they had any concerns about the quality of service received. They told us that they were encouraged to express their views at their monthly community and ward meetings and felt listened to by the consultant psychiatrist and staff. They told us that the occupational therapist and other staff were kind and gave them support to learn new skills to become more independent.

We found that patients gave consent for their treatment and received support that met their needs. We found there were sufficient numbers of staff on duty to meet patient’s needs and the patients were protected from unsafe or unsuitable premises.

Inspection carried out on 6 August 2012

During a routine inspection

We spoke with the majority of people living at the house and they told us that they were happy living at The Dallingtons. They told us that St Mathews Limited company took over the running of the home six weeks ago and that they liked them. They told us that since the new provider had taken over, the atmosphere in the home was calmer and that they had seen improvements had been made to the décor of the home. They also told us that they liked their bedrooms because they were spacious and nicely decorated.

The people also told us that they enjoyed being supported by the staff to go out into the community and they did different activities. All the people we spoke with told us that they felt safe living at the home. They told us if any body shouted or hurt them, they would tell the manager and the staff.

One person told us that the new staff were different because they talked to people in a better way. They said they were asked for their opinions about the activities they wanted to do and food they wanted to eat and that the provider told them what was happening in the home.