Durham House Residential Care Home

We found the following examples of good practice:

• The premises were clean and hygienic. Housekeeping staff followed a cleaning schedule that included regular cleaning of high touch areas such as door handles and switches.

• The home was following national guidance for anyone moving in.

• People were supported to understand the pandemic and the need for IPC measures.

Further information is in the detailed findings below.

Durham House Residential Care Home was providing personal care to 28 people aged 65 and over at the time of the inspection. The service can support up to 31 people.

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

People told us they were kept safe by staff who knew them well. Staff understood how to safeguard people and manage risks. The provider had carried out pre-employment checks on staff and ensured they were suitable to work in the service. One person told us, “I felt safe in this home in the time I’ve been here, and I can’t imagine other homes being any better. I’m quite content in here. The building is kept very clean and tidy and this can help with safety issues too”.

Although no one had come to any harm in relation to their medicines, staff were not following best practice guidance. We made a recommendation about this.

Regular checks were carried out on the building to make sure people lived in a safe environment. Following observations and discussions with the management team we contacted the local fire service to give advice to the provider about fire safety.

Professionals told us they had good working relationships with the manager and the staff. Staff referred people to healthcare professionals in a timely manner.

The provider had carried out a programme of refurbishment including redecoration and replacing the hot water system, and they planned to redecorate the upstairs corridors. People were living with dementia and adaptations to meet their dementia needs were limited. We made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives told us they had no reasons to raise a complaint. People received person-centred care which met their needs. Activities were provided in the home.

Staff treated people with kindness and respect. They promoted their dignity and independence. Interactions we saw between people and the staff team were very positive and relatives said they were made to feel welcome in the home.

Relatives were complimentary about the manager. They felt the manager was approachable.

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 (Report published 24 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

We previously inspected Durham House in February 2015, at which time the service was compliant with all regulatory standards and was rated Good. At this inspection the service remained Good.

Durham House is a care home in Chester-le-Street, Durham, providing accommodation for up to 31 older people who require nursing and personal care. There were 24 people using the service at the time of our inspection.

The service had a registered manager in place and a new manager in post, who was being supported through their probationary period.

Risk management processes were in place and regularly reviewed, such as risk assessments and falls analysis, protecting people against a range of risks.

There were ample staff on duty to meet people’s needs and keep them safe. The provider used a dependency tool to ensure there were always ample staff to meet people’s needs.

The management of medicines was safe and adhered to National Institute for Health and Care Excellence [NICE] guidelines. Where we identified an area that could be improved the provider responded promptly.

The service was clean throughout and the premises effectively maintained.

Staff were trained in safeguarding, health and safety, moving and handling, infection control, mental capacity, dementia awareness and food hygiene. Staff demonstrated a good knowledge of these topics.

There was a consensus of opinion that staff effectively supported and managed people’s healthcare needs through ongoing liaison with external professionals.

All people who used the service we spoke with, relatives and visiting healthcare professionals stated staff demonstrated caring attitudes towards people.

There were patient and compassionate interactions displayed by staff throughout our inspection.

The atmosphere and culture at the service was homely and welcoming.

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). The manager and staff displayed a good understanding of capacity and we found related assessments had been properly completed. The provider had fulfilled their legal obligations in relation to assessing and arranging requirements in the Deprivation of Liberty Safeguards (DoLS) for those people who needed them.

People’s nutritional and hydration needs were met. Menus were varied and people had choices at each meal as well as being offered alternatives if they changed their mind. The provider agreed to look into implementing communication aids such as photographs to help people make choices about what they would like to eat.

Person-centred care plans were in place and were regularly reviewed. The activities co-ordinator was in the process of producing a one-page background for each person to ensure there was a concentrated amount of person-centred information available to any new staff.

The activities co-ordinator had made a range of external links in the community and ensured there was a selection of activities available that people found meaningful and enjoyable.

There were a range of quality assurance, auditing processes and policies and procedures in place. Auditing had identified and led to improvements in service delivery. The manager, director and provider had produced and acted on an action plan to ensure the service maintained good standards of care at a time of managerial change.

Staff, people who used the service, relatives and external professionals spoke positively about the approachability of the new manager, who demonstrated a good knowledge of the service and people’s needs throughout the inspection.

People told us they could choose how to spend their day and the staff treated them with dignity and respect. One person said 'They look after my privacy and dignity all of the time."

Everyone said they would have no hesitation in making a complaint if they were unhappy. One person said 'If there was anything wrong, if I had any problems I would talk with the staff.'

Other comments from people included:

'I'm satisfied. They are very nice.'

'It's a really good home.'

'They find out what I like and don't like.'

'They provide a lot of entertainment.'

A relative said "I would recommend this home to others. My relative receives excellent care."

We watched how the staff supported the people in their care. We saw people were treated with dignity and respect. For example, when staff talked with people they made sure that they got down to their eye level. We heard staff address people respectfully and speaking quietly about private matters.

The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

The arrangements for keeping the home clean and tidy were more than satisfactory. The standard of the accommodation, d'cor and furniture and fittings were very good and provided a clean and comfortable place to live in.

There was a stable and competent staff team who had the training, skills and experience to meet the specific conditions of the people who lived there.

Without exception people told us this was a lovely place to live and that they were well supported by the staff and the proprietors.

Four relatives told us they were very pleased with the care and support of their relatives received. One relative described the care as "marvellous."