We carried out a responsive inspection of Durnsford Lodge due to safeguarding concerns that had been raised about the care of people who lived in the home. A pharmacist inspector was involved as concerns had also been raised about the management of medicines at the home. As part of this inspection we made an unannounced visit to Durnsford Lodge on 8 May 2012. At that time there were 24 people living in the care home and approximately 15 care staff were employed as well as catering and domestic staff. During the course of our visit we talked with seven people who lived in the home. We also spoke with one relative, two staff members, the registered manager, and one of the owners.
We also looked at records relating to the care and support people received, staffing arrangements, and policies and procedures relating to the operation of the care home.
People who lived in Durnsford Lodge said they were happy living in the home, felt safe, and were well cared for. Comments from people who lived in the care home and a relative included "I like living here", "we have a lot of fun between us" and staff "always have time to speak". We observed interactions between the staff and people who lived in the home and saw that staff were friendly, respectful, and attentive to the people they supported. People talked to us about their personal routines, the activities they enjoyed, and the meals provided in the home. People said there were enough staff on duty to meet their physical and health care needs supported by visiting healthcare professionals. We found that medication was kept securely in the home and was safely administered by staff. However the arrangements in place to manage particular medications, and the recording of the administration of medicines, were not protecting people against the risks associated with the unsafe use and management of medicines.
During our visit we looked all around the home including all the bedrooms. We found that the home was clean and there were no offensive odours. We found that regular audits of the premises/environment were not being carried out to identify and manage risks, for example, in relation to broken or missing window restrictors, the presence of which reduce the risk of people falling from windows. We found that fire safety procedures were not robust and, following our visit, we made a referral to the fire service due to our concerns regarding fire safety awareness in the home.
We found that people's right to privacy was not always respected. We found that the bedroom doors did not have locks fitted and locks on toilet and bathroom doors did not always work correctly. People were not consulted about the way the service was provided and delivered in relation to their care as they were not actively involved in the care planning process. Care plans were not comprehensive as they did not contain details of all the care needs that people had nor were they kept up to date as people's needs changed.
The provider had some elements of a quality monitoring system in place. However the issues we found during our visit identified that the system to assess and monitor the quality of service that people received was not effective.