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Inspection carried out on 29 November 2017

During a routine inspection

An unannounced comprehensive inspection took place of Dalemain House on 29 November and 4 December 2017.

Dalemain House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Dalemain House provides personal care and support for up to 24 older people. The home is located in a residential area, close to the town of Southport, which can be reached by the local transport services. The home is a large converted house and all areas are accessible by a passenger lift and there is ramped access to the front garden. Accommodation includes 11 single rooms and five double rooms which are situated over three floors. There has been a change of legal entity for this service and the registered provider (owner) is now Dalemain House Residential Home Ltd. Although an inspection took place in 2016 and the overall rating was found to be ‘Good’, the service was inspected in accordance with our methodology for new services. This is for services to be inspected between six to 12 months from the date of registration.

There was a registered manager in post at the time of our inspection. 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.

During the inspection we received information of concern around the fire doors being padlocked; a lack of fire training; lack of equipment for the first aid boxes and topical creams applied to people being out of date. We looked at these areas on inspection. The fire doors had been inspected by the home’s external fire contractor and no concerns had been raised by them or the fire service with regards to the fire doors and the locks. A further visit took place by the home’s external fire contractor following our inspection to confirm the use of these doors and padlocks. We saw staff had received fire prevention training and further fire prevention training was planned for 2018. We checked a number of topical creams prescribed for people; these were in date and applied as prescribed. We found some equipment needed to be replaced in the first aid boxes and this was rectified during the inspection. The safety check of these boxes was confusing. This was brought to registered manager’s attention and a more accurate record was put in place.

Staff were aware of what constituted abuse and how to an actual or alleged incident. Policies and procedures were in place to protect people from abuse and people we spoke with said they felt safe living in the home.

We found the home was operating in accordance with the principles of the Mental Capacity Act 2005 (MCA). Staff sought consent from people before providing support.

The registered manager had made appropriate referrals to the local authority applying for authorisations to support people who may be deprived of their liberty under the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the MCA and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.

Risks to people’s safety were assessed and monitored by the staff. This helped to maintain their safety and welfare.

People had a plan of care and received support from the staff and external health and social care professionals to help deliver effectives outcomes. Monitoring records and charts for fluids and diet, for example, were updated so they provided an effective evaluation of care.

People and/or their relatives had been included in the care planning, so they were involved in decisions around their care, support and treatment