Archived: Deepdene Care Centre

Updated 9 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 October 2015 and was unannounced. The inspection team consisted of three inspectors, an expert by experience and a nurse specialist. An expert by experience is a person who had personal experience of this type of home and a nurse specialist is someone who has clinical experience and knowledge of working with people who require nursing care. The nurse specialist who accompanied us during this inspection specialised in wound care.

We did not ask the provider to complete a Provider Information Return (PIR) on this occasion. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was because we had brought out inspection forward in June 2015 as we were responding to concerns and this inspection was a follow up from our June 2015 inspection to see if the provider had taken the necessary action.

As part of our inspection we spoke with 12 people, 13 staff (which included registered nurses, care staff, the chef, activities co-ordinator and maintenance person), nine relatives, the new manager, the provider’s quality lead, the provider’s training lead and one health care professional. We spent time in communal areas observing the interaction between staff and people and watched how people were being cared for by staff.

We reviewed a variety of documents which included 15 people’s care plans in varying depth, five staff files and policies and procedures in relation to the running of the home.

In addition, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law.

We last carried out an inspection to Deepdene Care Centre in June 2015 when we found breaches in Regulation 9, 10, 11, 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Updated 9 December 2015

Deepdene Care Centre is a purpose built care home that provides nursing and personal care for up to 66 people. Many of the people living in the home are living with dementia. The home is set across three floors. At the time of our inspection there were 54 people living at the home.

There was no registered manager in post. The new manager was in the process of applying to become the registered manager. 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 and associated Regulations about how the service is run. The new manager assisted us with our inspection on the day.

At our previous inspection on 8 June 2015, we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We had received an action plan from the provider following that inspection and we reviewed progress against that action plan during this inspection.

Although some improvement had been made, people did not live in a clean, hygienic environment. The provider had failed to act on all of the concerns we had identified at our inspection in June 2015. Quality assurance checks were carried out by staff and the provider to check the quality of the care. However, these did not always identify areas that required action. For example, the cleanliness of the home.

People were not always provided with the dignity and respect they should expect. For example, we saw staff pass meals over people’s heads during lunch time. However, we did some good examples of kind, empathetic care and staff were much more attentive to people than they were at our previous inspection.

There were a sufficient number of staff seen during the day, however we found particularly at lunch time, staff were not deployed appropriately. This resulted in people having to wait to have their lunch.

Staff had not always followed legal requirements in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Although we found some improvement had been made following our last inspection.

Some people were provided with a choice of meals throughout the day; however we found people on a pureed diet were not provided with the same choice. People’s individual preferences were not always recognised by staff. For example, one person who did not eat beef was given the beef option at lunchtime.

Staff had not been provided with up to date training or the opportunity to meet with their line manager on a regular basis to discuss their work. This meant staff may not have the necessary skills to support people and management was not checking staff were putting any training they had received into best practice.

We found more activities were being held following our inspection in June 2015, for example, we saw staff played games with people. However, further improvement was required to ensure activities were appropriate for people who may be living with dementia. The environment on the top floor was becoming a more suitable place for people living there because of improvements that had been made. For example, sensory items and memorabilia had been provided.

Care plans contained information to guide staff on how someone wished to be cared for. However, we found some information was missing which meant staff may not know the most up to date care information about people. People received responsive care.

Effective medicines management procedures were followed by staff which meant people received the medicines they required in a safe way.

Appropriate checks were undertaken before staff commenced work to help ensure that only appropriate staff worked at the home. Staff understood their responsibilities in relation to safeguarding concerns and knew how to report these if the need arose.

Accidents and incidents were analysed and action taken to mitigate the risk of further incidents. Staff had identified individual risks for people, for example in relation to their mobility or their skin integrity.

People had access to external healthcare professionals when they needed it and the GP visited the home once a week to help people maintain good health. Visitors were welcomed into the home at any time.

Complaint procedures were available for people should they have any concerns. Any complaints since our last inspection had been dealt with by the manager. Staff, people and relatives felt the manager was making positive changes.

People and staff were involved in the running of the home and were given the opportunity to give their feedback on the care they received.

During the inspection we found some continued and new breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.