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We are carrying out a review of quality at Dothan House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 December 2018

This comprehensive inspection took place on 23 and 24 October 2018 and was unannounced.

Dothan House 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.

It is a care home for up to 19 older people, some of whom may have dementia. At the time of our inspection, there were 13 people living in the home.

We last inspected the home on 22 and 23 February 2018 and we rated the service ‘Inadequate’. This was because we found breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2017. These were in relation to providing safe care and treatment, safeguarding people from abuse, providing person centred care, receiving consent to care from people, maintaining clean and safe premises, following safe recruitment processes, supporting staff with training and the overall governance and management of the service. In addition, the provider had also breached conditions of their registration. The provider sent us an action plan to tell us how they intended to improve the service.

We placed the service in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection, the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

We have now rated the service ‘Requires Improvement’.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the home is run.

The registered manager demonstrated the work they had carried out since the last inspection. We saw that improvements had been made in ensuring people were safer and they were protected from abuse. Staff were recruited appropriately and the necessary background checks were undertaken to ensure they were fit and proper persons. At our last inspection, we found serious risks to people as the home was not equipped to deal with the event of a fire spreading. The building had undergone a full fire safety inspection since our last inspection and was now compliant with fire safety requirements.

However, despite the improvements, we found there were some on-going issues because the safety of the premises was not always adequately maintained. A professional electrical installation safety check of the premises was judged to be ‘unsatisfactory’ and recommended electrical works to rectify the faults had not been completed. This placed people at potential risk of harm because the building and premises was not fully safe.

Risk assessments had improved but there was some inconsistency in how all risks to all people were assessed. We have made a recommendation in this area.

Medicines were managed more safely and there was a procedure in place for staff to follow. We found that records were accurate and up to date. However, some medicines were not administered in the correct method. We have made a recommendation in this area.

Complaints about the service were responded to appropriately and in a timely manner. However, complaints were not recorded fully and we have made a recommendation about complaints recording.

Staff had received an induction and training to ensure the service they provided to people was effective. Some staff required further training in key areas and we saw that this was scheduled. The provider did not always follow Mental Capacity Act 2005 processes to assess people's capacity

Inspection areas

Safe

Requires improvement

Updated 7 December 2018

The service was not always safe. Electrical repairs in the home had yet to be completed which meant the premises was potentially unsafe.

Risks to people were not always identified and assessed.

Staff understood how to safeguard people from abuse.

A recruitment procedure was in place to ensure staff were suitable to support people safely.

Staffing levels were sufficient to ensure people received support to meet their needs.

People received their medicines safely and staff received training on how to do this.

Effective

Requires improvement

Updated 7 December 2018

The service was not always effective. The requirements of the Mental Capacity Act 2005 were not always followed.

Staff received training and support, although additional training for staff had still to be completed.

Staff supported people with their nutritional requirements. However, people's fluid intake was not recorded effectively.

Assessments of people’s needs were carried out to ensure effective outcomes for their care.

Appropriate adaptations were in place in the home. People were supported to visit could health professionals to ensure they were in the best of health.

Caring

Good

Updated 7 December 2018

The service was caring.

People were treated with respect and dignity by staff. Staff knew people in the home well and were familiar with their care and support needs.

Staff respected people's privacy and confidentiality.

People and their relatives had involvement in the decisions made about their care.

People's rights and choices were upheld by staff.

Responsive

Good

Updated 7 December 2018

The service was responsive.

There was a complaint procedure in place.

Care plans were person-centred and reflected each person’s needs and preferences.

People's care needs were reviewed and monitored by staff. People's communication needs were met and understood by staff.

People were encouraged to participate in activities of their choice.

Staff supported people with end of life care sensitively and respectfully when required.

Well-led

Requires improvement

Updated 7 December 2018

The service was not always well led. There was a quality assurance system in place. However, this did not always identify shortfalls such as the issues we found during our inspection.

Staff received support and guidance from the management team.

People and their relatives were provided with opportunities to provide their feedback on the quality of the service.