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Dorcas House Requires improvement

We are carrying out a review of quality at Dorcas House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 November 2019

Dorcas House is a ‘care home’ that is registered to provide personal care and accommodates up to 11 people living with dementia or mental health need in one adapted building. There were five people living at the home on the day of the inspection.

People’s experience of using this service:

Since the last inspection in November 2018 we found limited improvements had been made to address the areas we had identified as requiring action, and further improvement was still required.

There was a failure to ensure all peoples risks were identified and managed well. People’s risks were known to staff however, care plans lacked detail on the de-escalation techniques to be used when one person was distressed. Further guidance was also required on people’s individual risks, including what the risk meant for the person concerned and information, so staff knew how and when to contact professional bodies for advice and guidance.

Staff knew people well and were able to demonstrate they knew people’s risks when providing care on a daily basis.

The registered provider had failed to take action to safeguard people from the risk of abuse. Two incidents had not been identified as safeguarding concerns by the management team so that the appropriate actions to alert the Local Authority and CQC had not been made. Both incidents were reported to the Local Authority by the inspector following the inspection.

People were supported to receive their medicines as required and general day to day practice supported infection control, but improvement could be made to ensure all equipment is maintained cleanly to promote good infection control.

Staff had an understanding of the importance of gaining consent from people before providing support. However, the Mental Capacity Act (MCA) includes how people are given choices about their care and how they want it delivered. Improvements are required as some people told us they felt they were not always involved in making decisions about how their care was delivered. The registered manager had a limited understanding of the principles of the MCA and would benefit from additional training. Deprivation of Liberty (DoLS) records need to improve to ensure expiry dates are monitored and new applications are made in a timely way, so people are deprived of their liberty in a lawful way.

Staff said training was appropriate to them in their role in supporting people’s daily care, however we saw that further training was required to support people’s individual care needs. For example, challenging behaviour training.

Staff liaised with other health care professionals to meet people’s health needs and support their wellbeing.

The design and decoration of the home did not support people’s individual needs and improvements were required for example, work in making the garden a useable space for people to enjoy.

People gave mixed feedback about the choice of food provided. We saw people were offered regular drinks throughout the day to support their wellbeing.

There was limited opportunity for some people to enjoy activities which would avoid their social isolation. Many of the activities planned were games and activities with staff within the home. People we spoke to told us they did not always enjoy the activities and sometimes chose not to join in.

The service has been rated as requires improvement in the key question ‘well led’ since February 2017 (and Inadequate from November 2018). Whilst this inspection found some improvements had been made, the provider audits had not been fully effective in effecting sustained improvement and had not identified some the concerns we raised at this inspection. The processes in place to monitor, audit and assess the quality of the service being delivered were not always effective.

No links to the immediate and local community had been developed or maintained and this was an area that needed improvement

Staff felt supported and communication within the staff team w

Inspection areas

Safe

Requires improvement

Updated 29 November 2019

The service was not always safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 29 November 2019

The service was not always effective.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 29 November 2019

The service was not always caring.

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 29 November 2019

The service was not always responsive.

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 29 November 2019

The service was not well-led.

Details are in our Well-Led findings below.