We carried out a review of the data available to us about Dulverton House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Dulverton House, you can give feedback on this service.
We found the following examples of good practice
All staff and essential visitors had to wear appropriate personal protective equipment (PPE), complete NHS Track and Trace information and had their temperature checked prior to entering the home.
Staff supported people’s social and emotional wellbeing. The provider and staff kept family members up to date about the latest government guidance. Relatives were kept informed about people's health using telephone and video calls and garden visits.
The registered manager had quality assurance systems in place to ensure safe care delivery.There was a communication system in place to ensure staff received consistent updates in relation to infection control policy and practice.
All staff had undertaken training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training. Additional competency checks regarding safe use of PPE was also carried out by the registered manager.
People’s experience of using this service: People felt safe and well cared for by staff who knew their needs and preferences. People told us they were given choices about their day to day life.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. Staff helped people and their families to make decisions in their best interests. Staff supported people to interact with one another and access the community. People joined in regular activities which supported their physical and emotional well-being.
People felt comfortable with staff that were patient and respected their wishes. Staff were kind and compassionate towards people and their relatives.
Staff paid meticulous attention to detail during end of life care. They were sensitive and professional in their approach and respected people’s religious needs.
People told us they felt safe living at the service. Risks had been identified and guidance was in place for staff to help avoid repeat incidents.
Recruitment procedures were robust and ensured prospective employees had values in line with the service’s aims and objectives.
Safety checks were regularly completed to make sure the environment was safe and equipment serviced regularly.
Care records were concisely written and person-centred. Staff described how they delivered person-centred care recognising each person’s individual needs and preferences.
Staff felt supported by the registered manager and their colleagues.
Quality assurance checks were in place to continuously improve service delivery. Management listened to staff, relatives and people's feedback to make positive contributions to people’s lives.
Rating at last inspection: Good. (Last report published 15 September 2016).
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected: The inspection was a scheduled inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
Dulverton House provides personal care for up to 22 older people, some of whom may be living with dementia. On the day of the inspection there were 16 people living in the home, which is located in the seaside town of Scarborough. Dulverton House does not provide nursing care.
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 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.
Staff were correctly able to tell us what they would do to ensure people were safe and how to refer any concerns to the correct agencies. People told us they felt safe at the home. The home had sufficient suitable staff to care for people and staff were safely recruited.
Staff had received training to ensure that people received care appropriate for their needs. Training was up to date in areas the registered provider considered mandatory, such as infection control, health and safety, food hygiene and medicine handling and also in specialist areas of health care appropriate for the people who lived at the home.
Staff had received up to date training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They understood that people should be consulted about their care and that they should assume that a person had capacity to make decisions. Staff understood what needed to happen to protect the best interests of people who did not have capacity to make certain decisions.
Some people told us they did not like all the meals they were offered. However, people’s nutrition and hydration needs were met and some people told us they enjoyed the meals. People were offered alternatives if they did not like certain menu choices. People’s clinical care needs were met in consultation with health care professionals.
People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with respect. Staff had a good knowledge and understanding of people’s needs and worked together well as a team.
Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were supported to feel cared for and listened to. Care plans were updated when people's needs changed.
People were supported to engage in daily activities they enjoyed. Staff understood what was important to people, their personal histories and social networks so that they could support them in the way they preferred.
People told us their complaints were responded to and the results of complaint investigations were clearly recorded. People we spoke with told us that if they had concerns these were addressed directly with the registered manager who responded quickly and with politeness.
The service was well managed. The registered manager ensured the quality of the service through a system of audits and checks. They sought feedback from people who lived at the home, relatives, visitors and professionals with an interest in the service and acted on this to improve people’s quality of care.
We carried out an unannounced comprehensive inspection of this service on 27 November 2014. At this inspection breaches of legal requirements were found. Staff were not able to correctly identify what they would do to protect people if they suspected abuse. This placed people at risk of harm. There were insufficient suitably qualified, skilled and experienced staff employed by the service to ensure people’s needs were met. People were not sufficiently consulted over choice and consent. People’s needs were not met in relation to eating and drinking. The environment of the home posed risks to people’s safety. People did not have access to sufficient stimulation or social interaction. Quality assurance systems did not ensure that people were kept safe or that the home was working towards improving people’s quality of life.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. They set a number of timescales in relation to meeting the breaches of regulation. They sent us a regular update of this plan with details of how they were improving. We undertook a focused inspection on the 6 August 2015 to check that they had followed their plan and to confirm that they now met legal requirements.
This report only covers our findings in relation to the breaches we found at the comprehensive inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dulverton House on our website at www.cqc.org.uk’
Dulverton House provides accommodation for up to 22 people who require support with their personal care. The home mainly provides support for older people and people living with dementia.
The home has a 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 and associated Regulations about how the service is run.
At our focused inspection on the 6 August 2015, we found that the provider had followed their plan and legal requirements had been met.
Staff were trained and knowledgeable about how to protect people from abuse and the risk of harm. There were sufficient staff to care for people safely.
Staff had received training and were knowledgeable around the main points of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards to ensure people were protected around issues of consent. The quality and choice of food had improved in consultation with people.
People were protected by the quality assurance systems of the home. The Registered Manager had developed a range of quality assurance audits and checks which provided information to protect people from harm and to improve people’s quality of life.
The Registered Manager had plans for improvements to the environment so that it was more suitable for the needs of people who were living with dementia. Some had been achieved, such as improvements in the quality of wall pictures and signage. However, these plans had not all been put in place and we made a recommendation about this in the full version of the report.
The Registered Manager had improved the range and suitability of personalised activities on offer; however, this was work in progress as some plans had not yet been put into place. We made a recommendation about this in the full version of the report.
We inspected Dulverton House on the 27 November 2014. This was an unannounced inspection. We previously visited the service on 26 November 2013 we found that there were no breaches of the legal requirements in the areas we looked at.
Dulverton House is situated in the seaside town of Scarborough. The home is on three floors and provides accommodation for up to 22 people who have personal care needs and or a dementia. The level of support provided at Dulverton House is also described in their Statement of Purpose. There is on street parking and a lift for those who have mobility needs to be able to access the upper floors. Some of the rooms have en-suite facilities. There are several communal areas for people to use.
There is a 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.
We found that people who used the service said they felt safe. However, during the course of the inspection would found some shortfalls in this area. Staff were provided with training in safeguarding of vulnerable adults but not all of them understood their responsibility for reporting any allegations of abuse. This was a breach of Regulation 11 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the full report.
We found that staffing levels were not always appropriate to provide the support needed by vulnerable people. At this inspection we found there were not enough staff available to assisit people with their meals or to ensure they were able to access activities. The staffing levels provided meant that where two staff were needed to provide care and support to one person other people were left unattended. This was a breach of Regulation 22 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the report.
Staff went through a thorough recruitment procedure and completed an application form with a full history of employment as well as a check to ensure they were suitable to work with vulnerable people.
People received their medication in a safe way administered by staff who had received training in the safe handling of medicines.
We saw that staff had access to training, this training was provided on line but there was no method to determine that staff had understood what the training meant in practice. We recommend that the provider looks at how they can reassure themselves that staff had fully understood their online training.
No-one using the service had a mental capacity assessment, staff were unsure as to what the Mental Capacity Act 2005 meant. This is a piece of law that sets out guidelines to demonstrate how people should be assessed to determine their understanding of the decisions they are making. This was a breach of Regulation 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the report.
People told us they didn’t enjoy the meals provided. People who used the service told us their was no choice at meal times and the quality of food provided was poor. We did not see anyone being asked if they had had enough to eat, if they didn't like the meal, if there was anything else they would prefer or if they were feeling well or needed help with the meal.This was a breach of Regulation 22 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the report.
We saw from records that people accessed health and social care professionals when they needed to. We spoke with three health care professionals who told us the service worked with them in a positive way to the benefit of people who used the service.
We found the environment had not been assessed for people with a memory impairment in line with current guidance. We also found that several carpets were worn and required attention. This is a breach of Regulation 15 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the full report.
All people said they felt their care needs were met. We observed that work was task orientated and individual needs were not addressed by staff unless directly requested. We also observed that staff carried out their tasks pleasantly and interacted with people who used the service but didn't show any understanding of continuous risk assessment and assessment of their mental state.
We saw that there was very little to orientate or motivate people, no newspapers or magazines and no obvious activities or people providing any sensory or mental stimulation for individuals who were vocal and willing to say what they liked and disliked. This meant the manager and staff were not taking in to account the social needs of people who used the service. This is a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the report.
During our inspection we found the manager to be disorganised. The office was disorganised and the manager found it difficult to locate files for us to examine. We found that the quality system was not robust enough to identify areas of improvement throughout the home meaning people could not be confident they lived in a safe environment. This is a breach of regulation 10 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The action we have asked the provider to take can be found at the back of the report.
We found that people were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable and nutritious food and drink. People enjoyed the food and made positive comments. The upkeep, monitoring and maintenance of the building was to a high standard and the environment was safe and free from hazards.
There were comprehensive quality assurance systems in place in the service which monitored the practical aspects such as gas safety and fire procedures. There were also opportunities for people who used the service, families and staff to feed back and be involved in the development and improvement of the service. People's personal records including medical records were accurate and fit for purpose.
When we visited in April 2013 we found that the care planning documentation had been restructured and updated. Care plans were detailed and person centred and were organised in a much more user friendly way. This meant that documentation was appropriate for the service.
One person who used the service told us 'The food and the staff are alright'. A relative told us 'She is safe here and well looked after'. Another relative told us 'We have been quite happy. The staff are all very nice'.
The care plan files we looked at were detailed but were not necessarily up to date or organised in an effective way. Some contained no details of the person's history or background. The care we observed was person centred but several people who used the service and relatives commented during the inspection that it was unusual for staff to be spending so much time with residents.
We looked at the amount of staff that were working in the home and found it to be appropriate. Feedback from people who used the service and relatives regarding staffing levels was not always positive. We also looked at the checks and recruitment of staff and found there were appropriate processes in place.
The complaints system being used in the home was appropriate, and there were opportunities for people who used the service and relatives to raise any issues or concerns through meetings at the home.
People also said that if they weren't happy they would tell someone. One person said they enjoyed doing the chair aerobics and tried to join in with all the activities available.