The Dene Lodge - Minehead

Updated 3 August 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Dene Lodge 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. The Dene Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at all the information we had received from, and about, the service since the last inspection.

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 seven people who lived at the home and one visitor. We also spoke with five members of staff and the deputy manager. Several people were living with dementia and were unable to fully express their views to us. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at a number of records relating to people’s individual care and the running of the home. These included three care plans, three staff files, minutes of staff meetings, a sample of medication administration records and health and safety records.

We gave feedback to the nominated individual by video call after the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 3 August 2022

About the service

The Dene Lodge is a residential care home. It is registered to provide care and accommodation to up to 39 people. The home provides support to older people including people living with dementia. At the time of our inspection there were 19 people living at the home.

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

People lived in a home where there was no registered manager in post and there were no effective systems to monitor quality or drive improvements. Records had not been updated to make sure they fully reflected people’s needs. This placed people at risk of receiving inconsistent or inappropriate care.

There was a task centred approach and culture within the home. This meant that people did not always receive person-centred care which promoted their well-being and independence.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support best practice.

People were helped with personal tasks by kind and patient staff. However, there was very limited social interaction for people when staff were not helping them with physical care. New staff had not received training or guidance on how to promote well-being for people living with dementia. This all resulted in people not receiving social stimulation. We have recommended that staff receive training in supporting people living with dementia.

People felt safe with staff who supported them and looked relaxed when staff helped them. Staff said they were confident that any concerns raised would be fully investigated to make sure people were protected.

People lived in a home which was well maintained and provided a pleasant environment. Several people commented how much they enjoyed spending time in the garden.

People were happy with the food provided although improvements were needed to meals served to people who required a specialist diet.

Staff worked well with other professionals to make sure people’s medical needs were monitored and met. People said that staff arranged for them to see a doctor or nurse if they were unwell.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 August 2021) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made in infection prevention and control practices and the provider was no longer in breach of regulation 12. However other breaches were identified at this inspection.

At our last inspection we recommended that the provider ensured that all staff were familiar with the Mental Capacity Act 2005 and the practicalities of making decisions in respect of a person who lacks capacity to consent to their medicines being administered. At this inspection we found that although staff had received training in the mental capacity act no learning from this had been put into practice.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We carried out an unannounced focussed inspection of this service on 7 July 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

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 of Safe, Effective and Well-led.

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 not changed from Requires Improvement based on the findings of this inspection.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Dene Lodge – Minehead on our website at www.cqc.org.uk.