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Inspection carried out on 30 December 2019

During a routine inspection

About the service

Darley Hall Care Home is a residential care home providing accommodation and personal care to 16 people aged 65 and over at the time of the inspection. The service can support up to 22 people. The home is in a rural area and bedrooms are spread over the two upper floors with communal facilities on the ground floor. Several lifts are available to access the upper floors of the home.

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

People were safe from avoidable harm and abuse. There were a suitable number of staff available to meet people’s needs who were suitably trained. Checks were completed to ensure staff were suitable for their roles prior to working at the service. People felt safe and secure within their environment and with the staff team supporting them. The service was clean and tidy.

People’s care was based on a holistic assessment of their needs and preferences. People were supported to access health care services to maintain their wellbeing. People’s dietary needs were met and people were given a wide variety of options at mealtimes. People enjoyed the food and drink and staff were available to support them with their meals. People were supported to make decisions and staff supported them in the least restrictive way possible and in their best interests.

People’s care plans were individual to them and contained detailed histories and information on how they wished to be supported. People’s privacy and dignity was respected at all times.

Staff knew people well and everyone felt like they were family. People were encouraged to maintain their own schedules and to pursue activities and interests individual to them. The staff supported people to remain as independent as possible.

Leadership within the service has stabilised following changes to the management team and the communication and operations had greatly improved. Systems were in place to monitor the quality of care delivered. There was a procedure in place to address complaints or concerns. A monthly newsletter was used to communicate information important to people and their relatives. Staff felt supported and could rely on managers to assist them where required.

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 26 April 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.

Inspection carried out on 8 February 2017

During a routine inspection

Darley Hall Care Home provides accommodation and personal care for up to 22 people. This included people living with dementia. At our inspection visit, 13 people were receiving care.

The inspection visit took place on 8 February 2017 and was unannounced. The service was last inspected on 3 September 2015 and was rated ‘Good’ overall. At this inspection we found the service remained ‘Good’ in four questions and ‘Requires Improvement’ in well-led.

There was no registered manager in post. The acting manager had been in post since August 2016 and they told us they would be applying to become the registered manager. 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 2008 and associated Regulations about how the service is run.

People told us they felt safe. Staff understood what constitutes abuse and how to report it, should they have any concerns. The provider had a safe recruitment process, which ensured new staff were suitable to work with vulnerable people. Pre-employment checks had been carried out. There were enough staff on duty to meet people’s needs.

Systems and processes were in place to ensure people received their medicines in a safe manner. Risks to people were identified and assessed and included in care plans. Procedures were in place for circumstances such as emergencies and untoward incidents.

The key principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were understood and people were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with dignity and respect; staff were kind and caring. People were supported to maintain relationships with family and friends. People were supported to maintain good health and had access healthcare professionals when needed.

People told us there was plenty of choice around meals and personal preferences. Special diets, were catered for; drinks were freely available as well as being offered periodically throughout the day.

Care plans were reflective of people and their individual needs; people had been asked to contribute to their care plans. People and relatives felt there were enough activities to keep people occupied; staff supported people to take part in activities.

People and relatives were involved in the service and their views had been sought. Auditing procedures were in place to assess, monitor and evaluate the quality of the service being provided. People and relatives felt able to approach the staff or the acting manager and felt listened to.

Inspection carried out on 3 September 2015

During a routine inspection

This inspection took place 3 September 2015 and was unannounced.

Darley Hall Care Home provides accommodation and personal care for up to 22 people. This included people living with dementia. At our visit, 20 people were receiving care.

At our last inspection on 14 January 2014, we found that the provider’s arrangements for the management of medicines were not safe. We also found the provider did not ensure suitable arrangements were in place for obtaining, and acting in accordance with the consent of people, in relation to the care and treatment provided. These were breaches of Regulations 13 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. At this inspection we found the required improvements had been made.

There was no registered manager as they had recently left and a new manager had been appointed and intended to register with CQC. 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 2008 and associated Regulations about how the service is run.

Medicines were stored, managed and administered safely. Staff received training in relation to safe handling of medicines and to ensure staff practices remained safe.

Staff had received training to carry out their role. The manager understood their role in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

We saw people being supported and assisted by staff who clearly knew people well and staff were knowledgeable about people and their needs. There were sufficient staff on duty to meet people’s needs. Staff told us they had completed training needed for their roles.

People were treated with dignity, respect and compassion. People told us they felt safe. There were policies and procedures in place to maintain people’s safety.

People were supported and assisted by staff who had been recruited through a safe and thorough process. Pre-employment checks had been carried out and included written references and evidence of identity. Checks were also carried out to ensure new staff were suitable to work in the care sector.

People were supported to access health and social care professionals when needed.

Procedures were in place with regards to emergencies and untoward incidents, such as falls.

Drinks were freely available as well as being offered periodically throughout the day. People were provided with a healthy, nutritional and varied menu.

Systems and auditing procedures were in place to assess, monitor and evaluate the quality of services.

People were supported to maintain relationships with family and friends. Activities were under review and being developed.

Inspection carried out on 14 January 2014

During a routine inspection

This inspection was unannounced which meant the provider and the staff did not know we were coming. Darley Hall Care Home supported older people who may have a dementia related condition. There were 19 people in residence when we undertook our inspection. We spoke with seven people living in the home, one visitor, four staff on duty, two visiting professionals and the registered manager.

People told us they were happy with the care they received and the staff were responsive to their needs. One person told us, �They are lovely, nothing is too much trouble. I�m being well looked after and if I need help they are here for you.�

Where people did not have capacity, a suitable assessment had not been carried out. The provider could not demonstrate decisions had been made in people�s best interest.

People using the service had care records which recorded how they wanted to be supported. The information we read in the care records matched the care, support and treatment we saw being delivered to people.

People told us they could make choices about their food and drink. We saw people were provided with a choice of food and refreshments. Snacks and drinks were available throughout the day.

We checked to ensure medication was stored and administered in a safe way. We found medication auditing required some improvement.

We checked records were suitably managed and stored safely. We saw that systems were put in place to manage record keeping and confidentiality.

Inspection carried out on 21 February 2013

During a routine inspection

There were twenty people living at the home at the time of our inspection. During our visit we spoke with four of them.

One married couple told us '' We are happy here, they look after us well and the food is okay. ''Another person told us ''You would never get better care, all the nurses are perfect. The manager is great. I am happy with my care.'' A fourth person told us ''Living here is next door to nothing. There are no trips or outings. The food is ordinary, nothing special.''

We also spoke to the relatives of two people who had just come to live at the home. They told us '' We chose this home specially. We visited other homes in the area and we felt that this was the best place. The staff are friendly and welcoming.''

Reports under our old system of regulation (including those from before CQC was created)