Dovecote View Chichester

Dovecote View Chichester is a care home registered to provide accommodation and personal care for up to 34 older people, including those living with dementia. At the time of the inspection there were 21 people living at the home.

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

The service had experienced an outbreak of Covid -19 that had impacted on people living in the service and staff.

Relatives spoke positively about the care their loved ones had received. One relative told us, “they go the extra mile for my mum. Our hats go off to the care staff at this time.” Relatives felt that the registered manager and staff had “done their best to keep people safe in the most trying of times.” Another relative told us, “the home is well organised and well managed. Staff tend to stay, and I have seen several of them progress into senior roles where they have shown professionalism and skill. In conversation with staff I was consistently reassured of their capacity to look after [persons] increasing needs”.

We were assured that the service was following guidelines for preventing and controlling infection (IPC). As part of CQC’s response to care homes with outbreaks of Covid-19, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

Relatives told us about how the registered manager and staff had worked to ensure people received safe care and how they felt involved in discussions around care planning including end of life care.

We were assured that people’s preferences and choices for their end of life care was considered and people were supported at the end of their life to have a comfortable, pain free and dignified death.

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.

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

Why we inspected

The targeted inspection was prompted due to concerns received about infection prevention and control and end of life care. We decided we would inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. The service had experienced an outbreak of Covid-19 affecting both people living at the service and staff. We were assured by practices the service had in place to manage outbreaks.

We looked at how people were supported at the end of their life to have a comfortable, dignified and pain-free death under the Responsive key question. This was in response to a concern that had been raised during the recent outbreak of Covid-19. We found evidence that the service had worked closely with people and involved family members in providing appropriate support to people that respected their preferences.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. The overall rating for the service has not changed therefore following this targeted inspection and remains Good.

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.

Dovecote View Chichester is registered to provide accommodation and personal care for up to 32 older people, including those living with dementia. At the time of the inspection there were 25 people living at the home.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

At the last inspection the service was rated as Good. The inspection report was published on 9 September 2016. At this inspection we found the service remained Good.

People’s experience of using this service:

People and their relatives said they were satisfied with the standard of care provided. For example, one person told us the staff were responsive in providing care when they wanted it. A visitor gave feedback to the Commission via the You Experience portal that people were well care for and the person they visited was, “looked after and very happy.” Relatives and people said they were consulted and consented to the arrangements for care. People told us there were enough staff who responded when they asked for assistance. We observed staff treated people well and in a kind manner. Staff paid attention to people, chatted with them, and, checked whether people needed any assistance. Staff demonstrated they promoted values of treating people with respect and dignity. Staff were motivated and enjoyed their work; for example, one member of staff said, “I love the job. I see people as family. I am passionate about the work.”

People said there was a choice of good quality food. We observed people were supported to eat and the lunch was enjoyable for people. A range of activities were provided for people and the home employed an activities coordinator. People confirmed they enjoyed the activities.

Staff were well trained and supervised. Staff said they felt supported and worked well as a team.

The home was comfortable, clean, hygienic and free from any offensive odours.

The service was well managed and a range of audits were used to monitor the quality and safety of the services provided. People said the staff and management were approachable. Residents’ and relatives’ meetings were held on a regular basis where agenda items included discussions about the home and food. Surveys were also used to monitor the views of people and relatives.

Follow up: We will review the service in line with our methodology for ‘Good.’

There was a registered manager in post. 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 2008 and associated regulations about how the service is run.

People and relatives said they felt safe and secure and had no concerns about safety at the home. Staff understood local safeguarding procedures. Staff knew what action to take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely.

Staff received regular training and there were opportunities for them to study for additional qualifications. Staff were supported by the management through supervision and appraisal. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). We found the registered manager understood when an application should be made and how to submit one.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences and people were able to bring in personal items to decorate their rooms.

People were supported by kind and caring staff who understood their job role. Staff took time to engage with people, providing reassurance and support. People had developed relationships with staff and told us the staff were kind, caring and that they treated them respectfully. Staff understood how to care for people in a sensitive way.

People were involved as much as possible in planning their care. The provider had introduced a computer based care planning system and this provided information about people’s support needs. The registered manager and staff were flexible and responsive to people's individual preferences and ensured people were supported in accordance with their needs and abilities. People were encouraged to maintain their independence and to participate in activities that interested them. People were supported to express their religious beliefs and to maintain their cultural or religious needs

The service was well led. The registered manager operated an open door policy and welcomed feedback on any aspect of the service. The registered manager and deputy manager monitored the delivery of care.

A system of audits were in place to measure and monitor the quality of the service provided and this helped to ensure care was delivered consistently. Suggestions on improvements to the service were welcomed and people’s feedback was encouraged.

There was a clear complaints policy and people knew how to make a complaint if necessary.

Below is a summary of what we found. At the time of our inspection there were 26 people living at the home. We spoke with five people who use the service, three relatives, the registered manager, the care manager, the chef and four care staff. We looked at four care files, staff personal files, four care plans and a number of relevant records.

We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe?

We found the service was safe. This was because care plans were comprehensive, reviewed on a regular basis and were up to date. There were individual risk assessments in place that were reviewed frequently and ensured that people who use the service were safe.

We spoke with five people who use the service and they told us that they felt safe at the home. They said that staff ensured their safety and they were able to make informed decision about any likely risk. We found risk assessments in place to ensure that the environment was safe for people who use the service and staff working there. There was a system in place for staff to report any incidents and learn from concerns raised to ensure the safety of people.

We found staff were properly trained and supervised and had the opportunity to improve their skills. This meant that people cared for by a team of competent staff.

The Care Quality Commission is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) and to report on what we find. While no applications had been submitted, appropriate policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We found the service was effective. This was because people were provided with clear and adequate information about what services were available to them prior to moving into the home. We found evidence of people's involvement in the process of their assessment and they told us they were made aware of the care and treatment they would receive from the home.

People we spoke with told us that they had control over their lives and were able to dictate what was appropriate for their individual needs. We found that people were able to give valid consent to the care and treatment they received.

We found that people's nutritional needs were met. The home used the malnutrition universal screening tool (MUST), to ensure that each person's nutritional requirement was evaluated and their dietary needs met.

Is the service caring?

We found that the service was caring. We noticed that each person had a personalised care plan that was reviewed on a regular basis. People we spoke with told us about the level of input they had in their care planning. We found that where people's needs had changed, their care planning had been amended accordingly to reflect the changes. This ensured the care and treatment they received were appropriate to their needs.

People we spoke with and their relatives told us the following: 'They are very caring and staff are there when you need them', 'X who is my keyworker is very helpful and always there to support me', 'The girls work hard and they do listen to you', 'My wife is well looked after', 'X the manager is always keen to hear what you have to say'.

We found that people were supported to maintain their dignity, have control over their independence and feel free to express their views.

Is the service responsive?

We found that the service was responsive. There was a system in place to deal with concerns and complaints. Where people had raised any concern or complaint, we found that the service had responded to them in a timely fashion and taken appropriate action as required. People we spoke with were aware of the complaints procedure. They felt that their views were taken into consideration and acted upon accordingly.

The home offered a range of activities and people were keen to be involved in the social events. We saw copies of monthly newsletter that informed people of events taking place at the home such as cream tea afternoon, movie afternoon, 1940's quiz, coffee morning and cake competition.

Is the service well-led?

We found that the service was well led. We found that the home carried out survey twice yearly about the quality of service they offer. We found the overall response to be positive about the quality of service delivered.

Where there had been queries raised within the survey, we found that the manager had responded to them appropriately and taken action to ensure that people's views were acted upon accordingly.

Staff we spoke with told us that they had very good support from the management, were able to express their views and felt that they were listened to. We found staff were clear about their role, accountability and worked well as a team supporting each other.

People told us they were happy with the care and support provided at Dovecote View Chichester.

One person told us that the service was, "Marvellous"

Another person told us, "It is very good here. I wouldn't want to go anywhere else".

We looked at people's individual care records and saw that they had been involved in the planning of their support. Staff demonstrated that they knew how care was to be delivered in line with people's wishes and preferences.

We looked at records relating to staff recruitment. They showed us that the provider had effective recruitment processes in place to ensure that people's care was delivered by staff who were of good character and had the right skills.

Staff told us they liked working at Dovecote View Chichester and felt supported by the management team. One told us, "You have time to take people out".

We looked at complaint records and saw that people were supported to make complaints when they were unhappy with aspects of the service. The service had an effective complaints procedure.

During our visit we spoke with four people who were using the service, five members of staff and two visiting relatives. People who used the service and their relatives told us that they liked living at the home and that the service met their needs. People told us that staff were kind and caring and that there was always someone around to provide help and support. Comments included. "The care was excellent and they treat us like individuals." and "it's lovely here, I love the view from my room."

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat or what activities they wanted to take part in.

We observed people being addressed in a respectful manner. We looked at peoples care plans and saw that the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

We saw that the service was audited by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

People said that they had no complaints about the service and that if they did they would speak to the staff or the manager.