Douglas Bank Nursing Home

Updated 15 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

Douglas Bank Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Douglas Bank Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a manager in post, and application had been made to CQC to become registered.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people that used the service and 8 relatives. We spoke with 10 staff, including care staff and the manager.

We looked at a range of documents including 3 care plans and risk assessments, and medicine records. We looked at 3 staff recruitment records and rotas. We looked at policies and procedures, audits, and health and safety records.

Updated 15 July 2023

About the service

Douglas Bank Nursing Home is a residential care home providing personal and nursing care to up to 40 people. The service provides support to people living with dementia, older people, younger adults, people with a physical disability and people with a sensory impairment. At the time of our inspection there were 37 people using the service.

Douglas Bank Nursing Home is set over 2 floors, with the ground floor dedicated to people with nursing needs and the first floor meeting the needs of people living with dementia. Both floors have good sized communal areas and people, and their relatives have access to a good-sized garden.

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

We have identified that improvements were required in the safe management of medicines, assessing risk regarding fire safety and the recording of risks to people’s health.

We identified improvements were required to assess, monitor and mitigate risks, and to improve quality.

People were kept safe from the risk of abuse. There were sufficient staffing levels with less reliance on agency staff compared to the previous inspection. The home was clean and comfortable, and people were protected from the risk of mistakes being repeated.

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 living at the home benefitted from a positive culture and were supported by staff that enjoyed their jobs. The manager encouraged staff to develop knowledge and skills and worked well with other agencies.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 August 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. Improvements have been made since the last inspection, however some changes are yet to be embedded and sustained, therefore the provider continues to be in breach of the regulation.

At our last inspection we recommended that the provider completed tasks to improve their health and safety systems, and to review their auditing processes to make sure issues were followed up. At this inspection we found that the provider had made improvements in these specific areas, however further improvements were required in other areas.

The service remains requires improvement. Although the service was rated good in 2021, it has previously been rated requires improvement in 7 consecutive inspections and inadequate in 1.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings at this inspection.

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

Enforcement

We have identified breaches in relation to the safe management of medicines, fire safety, and governance of the service.

Please see what action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.