Archived: Deepdene Care Centre

At the time of our unannounced inspection on 16 October 2018 there were 57 older people living at the home, many of whom were living with dementia.

There was a registered manager in place. 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. The registered manager assisted us with our inspection.

We last inspected Deepdene in September 2017 when we rated the service as Requires Improvement. This was because we found shortfalls in person-centred care plans, record keeping and governance. Following that inspection, the registered manager sent us an action plan telling us how when they planned to meet the regulations. We checked at this inspection whether or not they had followed their action plan and we found they had.

People lived in an environment that was adapted for their needs, checked for its safety and free from infection due to the good processes staff followed. People received the medicines they required and were supported to access healthcare professionals when needed. People’s risks had been identified and staff followed good practices to help ensure risks to people were reduced and as such accidents and incidents occurred less. Staff also recognised their responsibility in safeguarding in order to keep people safe from abuse.

People were cared for by a sufficient number of staff who had undergone induction and training for their role and had continued support from their line managers. Staff told us the culture within the staff team was good and the registered manager led the service well. Staff had undergone robust recruitment processes to help ensure they were suitable to work in the service.

People’s needs were assessed before they moved into the service. These pre-assessments formed the basis of their person-centred care plan which contained sufficient information to enable staff to provide effective and responsive care. People were enabled to make decisions about their care, remain independent and participate in activities in they wished.

Staff demonstrated a kind, caring and attentive approach to people and people told us they were shown respect and dignity. People were given a choice of foods and where people had specific dietary needs these were recognised. People were supported to maintain relationships that meant something to them. Where people had end of life wishes these were limited in their detail. We have issued a recommendation to the registered provider in this respect.

People’s consent was sought before care was carried out and where restrictions were in place for people staff followed the appropriate processes. People and relative’s complaints were listened to and responded to appropriately. We read the service had received many compliments and where people had made suggestions these were addressed. Staff also had the opportunity to provide feedback to make improvements. The registered manager worked with external agencies to help ensure continued improvement within the service for the benefit of people.

Health and safety checks were carried out within the service and on-going auditing undertaken to help ensure a good quality of care was provided. The registered manager submitted notifications in line with requirements.

This was an unannounced inspection that took place on 12 September 2017.

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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.

Some people’s care records were not accurate or did not reflect people’s most current needs. There was a lack of detailed guidance for staff found in some care plans and although staff knew people’s care needs we felt more information could be included in records about people’s personal histories. We found records relating to medicines were not always completed as they should be. Although there were a number of quality assurance checks carried out these did not always pick up on shortfalls in the records relating to people. The registered manager was responsive to our feedback and took immediate action to address concerns we highlighted to them. They also told us that people’s care records had recently been changed from paper to electronic records. They said this would eventually help to improve the safety of people and the quality of care as in time more accurate information will be available for staff. Following the inspection the registered manager sent us an action plan detailing how they would ensure all actions we had identified had been addressed.

Care was provided to people by staff who were trained and received relevant support from their manager.

Staff were knowledgeable in relation to their responsibilities concerning safeguarding and keeping people free from abuse. The registered manager had worked closely with external agencies to investigate and follow up on some of these concerns. Risks to people had been identified and where accidents and incidents occurred these were recorded and analysised to look for trends.

Overall there was a sufficient number of staff on duty and people received support when they needed it. People received a variety of foods and were regularly offered juices throughout the day. Where people had a specific dietary requirement this was known by staff.

On the whole there was a good atmosphere in the home. People were shown dignity and respect by staff and staff were attentive to people. People and relatives were happy with the care provided and they were made to feel welcome when they visited. Staff supported people to take part in various activities.

The registered provider carried out robust recruitment processes in order to help ensure only suitable staff worked at the home. Staff felt supported and valued by the management team. They told us they enjoyed working at Deepdene.

Staff were involved in the running of the home as regular staff meetings were held. People and their families were asked for their views about all aspects of their care in the way of residents and relatives meetings.

Staff followed the principals in relation to the Mental Capacity Act 2005 (MCA). Where people had restrictions in place to keep them safe appropriate DoLS applications had been submitted.

Staff maintained people’s health and ensured good access to healthcare professionals when needed. For example, the doctor, dietician or district nurse.

Complaint procedures were available to people and there was a contingency plan in place should there be an emergency in the home or it had to be evacuated.

During our inspection we found two 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.

This was an unannounced inspection that took place on 7 December 2016.

The home had a 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 registered manager assisted us with our inspection on the day.

We carried out an inspection to this home in October 2015 where we identified five breaches of the HSCA (Regulated Activities) Regulations 2014. This included a lack of clean or well-maintained premises, a failure to following the legal requirements in relation to the Mental Capacity Act (2005), a lack of person-centred care, a lack of training and supervision for staff and a failure to always treat people with dignity and respect. We undertook this fully comprehensive inspection to check that the provider had taken appropriate action to address the concerns we had identified.

People were cared for by a sufficient number of staff. People’s needs were responded to in line with their care plan and in a prompt manner. Staff demonstrated a caring attitude towards people. One that showed people respect and made them to feel as though they mattered. The relationships between people and staff were relaxed and friendly.

People felt safe living within the home and where risks had been identified for people or they had experienced accidents or incidents staff took appropriate action. Staff had a good understanding of what they should do if they had any concerns about how people were being cared for and the provider had robust recruitment processes in place to help ensure that only appropriate staff were employed in the home.

People’s medicines were managed in a safe way and when people needed to see the doctor or another healthcare professional they were supported to do so. In the event of an emergency people’s care would continue with the least disruption possible.

People were given the opportunity to make their own choices and staff followed the legal requirements in relation to consent to ensure people’s views had been considered. People told us they enjoyed the food at Deepdene and could have alternative meals if they did not like what was on offer. Where people had specific dietary requirements these were recognised by staff.

People were cared for by staff who were supported by management. They had been given access to all the necessary training to allow them to carry out their roles competently and they had regular opportunities to meet with their line manager to discuss their performance.

A range of activities took place within the home, although people told us that they would like more opportunity to go on outings. People and their relatives also told us that at times the laundry service within the home was not as good as it could be. The registered manager demonstrated to us they had listened to people and were actively working on ways to improve these two areas.

People’s care plans were person-centred and contained information for staff in order that they could provide people with appropriate care. If people were unhappy about any aspect of their care they told us they felt confident they could speak to the registered manager.

The registered manager had good management oversight of the home and new the people who lived there. She demonstrated a strong desire to continue to improve the service that Deepdene provided and was very responsive to any suggestions or comments we raised with her during our inspection.

Good quality assurance processes were in place to monitor the quality of care provided.

During our inspection we made some recommendations to the registered provider.