Dearne Valley Care Centre

We found the following examples of good practice.

On arrival to the home, essential visitors were asked sanitise their hands, wear a facemask and have their temperature checked. Visitors were also asked to confirm they had their COVID-19 vaccinations or evidence of exemption. This assisted in identifying visitors who may be at a higher risk of transmitting an infection to people living in the home.

The premises were very clean. Staff followed cleaning schedules to ensure all areas of the home were regularly cleaned. Enhanced cleaning was completed of frequently touched surfaces. Suitable cleaning products were used to control the spread of infection.

Staff had received training about how to keep people safe from the risk of infection and how to use personal protective equipment (PPE) correctly. The provider ensured there was enough PPE available for staff at all times. We observed staff wearing appropriate PPE.

Staff had taken steps to support people in maintaining contact and visits with family and friends. The provider was aware of updated government guidance in respect of visits to care homes during a COVID outbreak. This guidance was displayed in the entrance area of the home. Information has also been made available to peoples’ relatives/advocates about the role of becoming an ‘essential care giver’.

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

We found the following examples of good practice.

Families and friends had received up-to-date information about visiting restrictions. Alternative arrangements such as window and garden visits had taken place using an appointment system. People had been supported to keep in touch with relatives and friends by using technology such as Skype and Zoom calls, as well as telephone calls. The home had purchased a screen to support safe indoor visits.

All visitors to the home followed clear procedures, such has having their temperature checked and wearing personal protective equipment (PPE). Clear areas were designated for putting on and taking off PPE.

Staff take breaks one at a time and remain socially distanced from one another wherever possible. People were supported to self-isolate in their rooms. Staff supported people with individual activities in their rooms, such as quizzes and crafts. Signs on people’s doors who had tested positive reminded staff to wear full PPE before entering. Some people who were at an increased risk of a deterioration in their mental health were supported to stay in their rooms with their doors open. Care plans documented the individual support people needed to self-isolate.

Staffing had been arranged considering staff working in cohorts and to minimise staff movement around the home. Arrangements were in place for meals to be delivered to people’s rooms without staff movement across different zones in the home.

PPE stations were well-stocked. Staff were observed wearing appropriate PPE. The registered manager had developed a range of procedures to ensure check staff were wearing PPE appropriately. Reminders about the use of PPE were placed in discrete areas throughout the home. Clinical waste bins were contained in bathrooms designated for putting on and taking off PPE, and this was disposed of securely.

Testing took place as set out in government guidelines. Staff were tested for Covid on a weekly basis. People were tested for Covid every 28 days. Staff had received specific training on how to swab people for the Covid tests and had learnt how to support people through the testing process.

The home was cleaned regularly using products appropriate to minimise Covid. Handwashing was encouraged.

Further information is in the detailed findings below.

Dearne Valley Care Centre is a residential care home providing personal and nursing care for 26 people at the time of the inspection, some of whom were living with dementia. Accommodation was provided in a purpose-built home across two floors, with communal areas on each floor.

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

People were pleased with the quality of care and support they experienced. They told us they felt safe when care workers were providing support to them. One person told us, “I feel safe because there is always staff around."

Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the registered manager. Safe procedures were in place to make sure people received their medicines as prescribed.

There were enough staff available to make sure people’s care and support needs were met. The provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Staff received training which supported them to have the knowledge and skills to do their job well and effectively meet people’s needs.

Staff understood the requirements of the Mental Capacity Act 2005. 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 were supported to access relevant health and social care professionals to ensure they were getting the care and support they needed to best meet their needs.

Positive and supportive relationships had been developed between people and staff. People were treated with dignity and respect. Staff were committed to promoting people’s independence. People were supported to maintain a balanced diet.

People’s care and support was planned and delivered in a way that ensured it met their needs and reflected their preferences. The care records we looked at included risk assessments. They had been devised to help minimise and monitor the risks, while promoting the person’s independence as far as possible.

People knew how to complain and were confident the registered manager or other staff would resolve their complaint.

People who used the service, relatives and staff could express their views about the service which were acted upon. The management team provided leadership that gained the respect of staff and motivated them as a team.

There were systems in place to monitor the quality of the service and make improvements when needed. These included audits staff training supervision and appraisal, environmental audits and audits of pressure cushions, slings hoists and bed rails. All show actions that had been taken in response to completing audits.

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 18 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.

There was a manager at the service who was registered 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 and associated Regulations about how the service is run.

Our last inspection at Dearne Valley Care Centre took place on 25 August 2015. The service was rated as Requires Improvement. We found breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulations 12: Safe care and treatment, 11: Need for consent and Regulation 18: Staffing. Requirement notices were given for these breaches in regulation. The provider sent an action plan detailing how they were going to make improvements. At this inspection we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of these regulations.

This inspection took place on 8 March 2017 and was unannounced. This meant the people who lived at Dearne Valley Care Centre and the staff who worked there did not know we were coming. On the day of our inspection there were 33 people living at Dearne Valley Care Centre.

People spoken with were positive about their experience of living at Dearne Valley Care Centre. They told us they felt safe and they liked the staff.

We found systems were in place to make sure people received their medicines safely so their health was looked after.

Staff recruitment procedures ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role.

Some staff were not provided with supervision and appraisal at identified frequencies for their development and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity were respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

At the time of our inspection, 30 people were living at Dearne Valley Care Centre. We spoke with five people who lived at the home, four relatives, the regional manager, the home manager, one nurse, two care workers and a cook. We also reviewed records relating to the management of the home which included four care plans, audits, incident reports, meeting minutes and other relevant documentation.

Below is a summary of what we found. The summary describes what people we spoke with told us, what we observed and the records we looked at.

Is the service safe?

There were risk assessments in place where required for people using the service in relation to their support and care provision. These were reviewed and amended as necessary to ensure that risks were mitigated, whilst still allowing independence, to ensure people's safety in relation to their care and support.

Most people said they felt there were enough staff at the home. Comments included 'I've got a buzzer in my room, staff come to help me' and 'brilliant staff, they don't leave [my family member] all day, if he needs anything they will do it, no concerns at all'. However, one person and a staff member had concerns that staffing levels at night were not always sufficient.

Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Policies and procedures were in place to make sure unsafe practice was identified and people were protected. This reduced the risk to people and helped the service to continually improve.

People's care files were stored securely and records of people were reflective of their needs.

The home had policies in place in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS), and staff received training in this. One person at the home had a DoLS authorisation in place and other requests were in progress. The manager understood how to make the applications and in what circumstances they were required. This demonstrated safeguards were in place to protect people's welfare in line with relevant legislation.

Is the service effective?

People at the home were happy with the care they received and felt this was suitable for their needs. It was evident from speaking with staff they know people well and recognised what support people needed. People at the home told us, 'I need help to get about and they [staff] always help me out, they've all been good' and 'it suits my purposes'. One relative said, 'I feel my [family member] wouldn't be alive today if it wasn't for this home, they're brilliant, excellent care'.

People received a varied, well balanced diet and measures were in place to ensure people received adequate nutrition and hydration. Everyone we spoke with was complimentary about the food we saw that that any dietary requirements were taken into account by staff. One person said, 'the cook will send things up for me I can eat making sure there's nothing in I can't have'.

Is the service caring?

During our visit we saw care workers interacted positively and gave encouragement whilst supporting people. People said, 'It's been great here, the lasses are brilliant'. A relative we spoke with said, 'my [family member] physically looks a lot better (than where they were previously), staff are very friendly, very approachable, can't fault them'.

The three care staff we spoke with all demonstrated they had a detailed understanding of people's care needs. Each staff member was able to describe actions they would take in relation to specific events and incidents, in a way to ensure the peoples' safety and welfare.

Is the service responsive?

People's needs had been assessed before they moved into the home. Care plans were in place for each individual covering a number of areas including mobility, falls, weight, medication and capacity. Information was reviewed regularly and in response to any changes in needs. Updates and amendments were made where required. We saw contact with, and referrals to, other professionals had been made where necessary.

On the day of our inspection we saw people, where they were able to, moved freely about the home. One person spent time gardening in the outside area. Some people chose to spend time in their rooms. Staff told us they tried to spend time with people individually. Three relatives we spoke with told us this took place, one person saying 'staff spend one to one time with my [family member]'. People had opportunities for social and mental stimulation and to engage in meaningful activities.

Is the service well-led?

The home worked with other agencies and services to make sure people received their care in a co-ordinated way.

Staff, people and relatives had confidence in the new manager at the home who was being supported by the regional manager.

There was a detailed quality assurance system in place and records seen by us showed that identified shortfalls were addressed. This meant that actions to continuously improve were in place.

Customer satisfaction surveys were sent to people in the home and other stakeholders in order to formalise views of the home. Feedback was also sought by way of daily discussions and relatives and residents meetings.

Discussions on best practice, improved ways of working and incidents reviews were common throughout formal team meetings and informal discussions.

The concerns related to the first floor of the home which is where people lived who may have had dementia and had nursing needs. Our inspection was therefore concentrated on this floor only.

We found that care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.

The manager identified on this report was not the manager at the time of our inspection. A new manager had been appointed within the last month who was applying for registered manager status.

We visited the service on 9 May 2013 as part of our scheduled inspection programme and also to check the service had become compliant with their action plan. We found that the home had achieved compliance with each outcome area checked.

People were treated with respect and dignity and were given opportunities to be involved. One person said, 'we do arts and crafts and reading'. The home employed an activities co-ordinator and we saw minutes of relatives and residents meeting that were held at regular intervals.

People experienced care, treatment and support that met their needs. Staff were knowledgeable about people's needs. One relative we spoke to said, 'I'm really pleased with how they (the staff) look after her'. People had their own individual care records with their care needs documented.

People were cared for by staff who were properly trained, supervised and supported. Staff had the opportunity to acquire further training and skills that would be beneficial to their roles.

People's personal records were accurate, fit for purpose and held securely.

People experienced care, treatment and support that met their needs and protected their rights. The activity worker had a positive affect on people's wellbeing, because she provided one to one attention for people, which meant some people were much calmer and less agitated.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises, but people and staff were at risk of exposure to a health care associated infection arising from clean and dirty laundry being in close proximity and staff carrying dirty laundry through communal areas.

A full employment history, together with a satisfactory written explanation of any gaps in employment was not in place for staff that had been employed, as part of an effective recruitment procedure to make sure staff were suitable to work with vulnerable adults.

People could be confident that any complaints they had would be listened to. Relatives told us they were not aware of the complaints procedure, but said they would have no hesitations in complaining to the manager.