Archived: Dorset Lodge Limited

Updated 6 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 September 2018, was completed by one inspector and was unannounced.

Prior to the inspection we reviewed the information we held about the service including the last inspection report and statutory notifications which contain information about important events which the provider is required to send us by law. We also looked at information supplied by the provider using the Provider Information Return (PIR). The PIR is a form that asks the provider to give us key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the deputy manager and two other members of staff. We spoke with four people who used the service and requested feedback from two professionals who commission services from the provider.

We looked at three people's care plans and three staff files. We also reviewed other records relevant to how the service was managed, such as quality audits, minutes of meetings and staff supervision and appraisal records.

Updated 6 December 2018

This comprehensive unannounced inspection was carried out on 7 September 2018 and was unannounced. At the last inspection on 9 March 2016, the service was rated as ‘Good'. At this inspection we found the service was in Breach of Regulations 9 and 17 and has been rated as ‘Requires improvement’.

Dorset Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Dorset Lodge provides accommodation and personal care for up to 9 people in a large house situated in a residential area close to local amenities. At the time of inspection 4 people were living at the service. Each person had their own room with en-suite facilities.

There was a registered manager in post who was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

The systems and processes for auditing medicines required strengthening to ensure robust oversight of people's medicines.

We made a recommendation about medicine management.

Health and safety checks, maintenance and fire drills were regularly completed, however environmental audits had failed to identify potential safety issues we found within the home environment.

We made a recommendation about environmental safety.

There were sufficient staff employed who had been safely recruited. Disclosure and barring service (DBS) checks to ensure staff were suitable to work with vulnerable people were completed but were not routinely renewed. Risk assessments had not been completed to support decision making regarding whether to renew staffs DBS.

We made a recommendation about safe recruitment practices.

People felt safe living at the service. Staff and the management team understood their safeguarding responsibilities and knew how to protect people from the risk of abuse.

Risks to people had been assessed and guidance was in place for staff to follow to ensure people’s safety and well-being.

Staff received an induction, training and supervision to support them to be competent in their role. Staff felt well supported and were regularly observed to check their performance and identify any learning needs.

People were assisted to have enough to eat and drink and received support to access treatment from healthcare professionals to maintain their health and wellbeing.

Staff were kind and caring and listened to people. People's consent was sought before care and support was provided.

People were treated with courtesy and respect and independence was encouraged. The service supported people to maintain relationships that were important to them.

We made a recommendation about the physical environment to support dignified practice.

People’s needs had been assessed and care plans devised which provided guidance to staff on how to meet those needs. However, care plans did not always contain personalised information to support staff to deliver person-centred care.

We made a recommendation about person-centred care planning.

People had the freedom to come and go as they pleased during the day and enjoyed past-times of their own choosing. However, restrictions were in place with regard to meal timings and sleeping and waking routines.

This was a breach of Regulation 9, [person-centred care].

There were systems and processes in place to respond to complaints and people knew how to make a complaint if needed.

The registered manager was not a visible presence within the service resulting insufficient oversight of the service and staff. Consequently, the systems and processes in place to monitor the safety and quality of the service were not robust.

Lessons had not always been learned and systems and processes had not been amended to improve the safety and quality of the service.

Feedback from people about the service was regularly requested, however was not always acted upon.

This was a breach of Regulation 17, [good governance].

Staff enjoyed working at Dorset Lodge and felt well supported by the deputy manager. Staff were included in the running of the service through staff meetings and an annual staff survey.

The service worked in partnership with external agencies to promote good outcomes for people.

Further information is in the detailed findings below.