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Reports


Inspection carried out on 8 July 2019

During a routine inspection

About the service

Dorset House is a residential care home providing personal and nursing care for up to 42 older people within one large adapted building. At the time of our inspection, there were 35 people living at the home.

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

People were supported with their individual needs however care documentation was incomplete. This had the potential to result in people's needs not being responded to in a consistently personalised way. We made a recommendation about this.

People who lived at the home and their relatives were positive about the care and support provided by staff. The registered manager and their staff team worked in partnership with other health and social care professionals to provide responsive and continuous care to people.

People told us they felt safe at the home. Risks to people were managed without placing undue restrictions upon them. Staff were trained in recognising and understanding how to report potential abuse. Staffing arrangements were regularly reviewed by the registered manager to ensure these continually supported people's safety. Staff knew how to reduce the risks of infections.

Staff were recruited safely; they received regular support and training. New staff were provided with an induction which provided them with the relevant knowledge and skills for their roles. The registered manager reviewed staffing arrangements on a regular basis, so they could continually improve these when required to effectively meet people’s individual needs.

People were supported to receive their medicines and were happy with the arrangements in place for staff to assist them with their medicines. People we spoke with told us staff responded to their health needs. People were supported to eat and drink enough and had a choice as to where to eat their meals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff always respected people’s privacy and dignity. People were supported to engage in things for fun and interest. The registered manager reviewed the opportunities people were offered to ensure they continued to be of interest and benefit to people.

Some information was in accessible formats and the registered manager was aware of broadening this out to further support the individual needs of people who lived at the home. People's concerns and complaints were listened and responded to.

Staff felt supported by their colleagues and the registered manager and spoke positively about the care they provided. They felt able to share issues and ideas to make improvements for the benefit of people who lived at the home.

There were quality assurance systems and processes in place to monitor and improve the quality and safety of people’s care. These had worked effectively to drive through the improvements following the last inspection. The registered manager would use their quality monitoring systems to make further improvements to people’s care documentation.

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

Rating at last inspection

The last rating for this service was Good (report published on January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 14 December 2016

During a routine inspection

The inspection took place on the 14 and 15 December 2016 and was unannounced.

Dorset House is registered to provide accommodation for up to 42 older people who need nursing care. On the day of our inspection there were 35 people living at the home.

There was a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

We carried out an unannounced comprehensive inspection of this service on 3 December 2015 when we found there was improvement required with how the service supported people safely. The provider agreed they make the necessary improvements. At this inspection we saw improvements had been made.

People and their relatives said they were happy with the support staff provided. Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. They were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them.

Staff had up to date knowledge and training to support people. People's permission was sought by staff before they supported them. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well and were authorised to do this. Staff met people's care and support needs in the least restrictive way. When it was identified that people received care and support to keep them safe and well which may have restricted their liberty applications had been made to the local authority for authorisation purposes. We saw people had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. People told us they had access to health professionals as soon as they were needed.

People told us staff were caring and promoted people’s independence. They said they were able to maintain important relationships with family and friends. People told us they were supported in a discreet and dignified way. We saw staff treated people with dignity and respect whilst supporting their needs. They knew people well, and took people’s preferences into account and respected them. Staff respected people's rights to make their own decisions and choices about their care and support.

Relatives we spoke with said they felt included in planning the support their relative received and were kept up to date with any concerns. They knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns.

The management team did not consistently action feedback received about the quality of the care provided. People and their relatives had raised concerns about how staff supported them during meetings with the registered manager during the three months before our inspection. Systems in place to monitor service provision did not consistently identify were improvements were needed. Management tools were not always effective to support the registered manager to provide quality care to people living at the home.

Inspection carried out on 3 and 4 December 2015

During a routine inspection

Dorset House is registered to provide accommodation for up to 42 older people who need nursing or personal care. There were 35 people living at the home on the day of our inspection.

There was a registered manager in post when we visited. 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.

There was now a new provider in place who registered with us in October 2015.

People and their relatives told us that they felt safe and staff treated them well. However, because of staff vacancies and sickness sometimes there was a lack of staff to meet people’s care needs. Staff we spoke with demonstrated awareness and recognition of abuse and systems were in place to guide them in reporting these.

Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them. Staff had up to date knowledge and training to support people who lived at the home. Staff knew people well, and took people’s preferences into account and respected them.

People were able to make choices about their day to day care and staff supported them to make decisions in their best interest. The registered manager had identified that some people would need assessments by the local authority to ensure people did not have their liberty deprived in an unlawful way. Applications had been submitted to the supervisory body so the decision to restrict somebody’s liberty was only made by people who had suitable authority to do so.

We saw staff treated people with dignity and respect whilst supporting their needs. Staff really knew people well, and took people’s preferences into account and respected them. We saw people had food and drink they enjoyed, the cook regularly consulted the people living at the home to ensure people had their choices available to them, to maintain a healthy diet.

People told us they had access to access to health professionals when they needed to. Relatives told us they were constantly updated about their family member and were involved with their care provision. People were able to see their friends and relatives as they wanted. People were encouraged to maintain important relationships. People and their relatives knew how to raise a complaint and were confident action would be taken if needed. The registered manager had arrangements in place to ensure people were listened to.

People were involved in some pastimes they enjoyed. People told us about links with the community and how they were developed. For example the local nursery provided a nativity play for the people living at the home. Staff knew people and their needs well. People who lived at the home and staff were involved in regular meetings and had been supported during the changes in provider.

The registered manager and the new registered provider promoted a positive approach to include people’s views about the service development. Staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service. New systems were in the process of being established to monitor and improve the service, these were still in their infancy therefore we were unable to see the full benefit to people living at the service.