6 May 2021
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 Care Act 2014.
Our inspection was prompted by our data insight that assesses potential risks at services, concerns in relation to aspects of care provision and previous ratings
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.
This inspection was carried out by two inspectors.
Service and service type
Derwent Residential Care Home 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
Notice of inspection
We gave a short period notice of the inspection. This was because of the Covid-19 pandemic. We needed to know about the provider’s infection control procedures.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with people who used the service throughout the inspection. Due to their dementia, people were not always able to give feedback about their experience at the home. Therefore, we spent time talking with them and observing their interactions with staff. We spoke with six members of staff including the registered manager.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted eight relatives and received feedback from seven of them through phone calls and emails.
We contacted a further thirteen staff, including the provider and received feedback from nine of them through phone calls and emails. We contacted six health and social care professionals who have involvement with the service and received feedback from three of them.
6 May 2021
About the service
Derwent Residential Care Limited is a residential care home providing accommodation and personal care to 21 older people, some of who were living with dementia. The service can support up to 30 people.
People’s experience of using this service and what we found
We found that improvements had been made following the last inspection. People’s care plans provided good guidance for staff about people and how to support them. There was a training plan and the registered manager had oversight of staff training and support needs. Quality assurance systems and audits helped to identify areas where improvements and developments were needed and records demonstrated these were addressed.
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.
There were systems in place to ensure people were safe. Infection prevention control measures meant people were kept protected, as far as possible, from the risk of Covid-19. The registered manager and staff were proud there had not been an outbreak at the home. Visitors were being welcomed back to the home in line with government guidelines. Throughout the pandemic visitors for people receiving end of life care had been supported.
People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. There were enough staff working to provide the support people needed.
Recruitment procedures ensured only suitable staff worked at the service. Risk assessments provided guidance for staff about individual and environmental risks. Staff understood the risks associated with the people they supported. People received their medicines safely, when they needed them.
People needs and choices were assessed and planned for. Staff received regular training and supervision which enabled them to provide the care and support people needed. People were supported to eat and drink and choice of meals and snacks throughout the day. They were supported to access healthcare as needed.
There was a positive culture at the service. The registered manager had a good oversight of the home and was supportive to people and staff. People, relative’s and staff views had been sought and acted upon to further improve the service.
Rating at last inspection
The last rating for this service was requires improvement (published 24 April 2019).
At this inspection we found improvements had been made.
Why we inspected
This inspection was prompted by our data insight that assesses potential risks at services, concerns in relation to aspects of care provision and previous ratings. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. This enabled us to look at the concerns raised and review the previous ratings.
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 reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from poor care provision. Please see the safe, effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Derwent Residential Care Home on our website at www.cqc.org.uk.
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.