Background to this inspection
Updated
28 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Dover Court 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was carried out over three days; 14 and 22 August 2019 which was unannounced and 12 September 2019 which was announced, so we could give feedback with the provider present.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included feedback we had received direct to the CQC through our ‘share your experience’ webpage, and telephone contact.
We sought feedback from the local authority and professionals who work with the service. We reviewed but did not use the information the provider sent us in the provider information return, as we were aware it was out of date, and the provider had been requested to submit a new one. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. Although this information helps support our inspections, we found the provider’s action plans following our last inspection, more informative.
We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service, five relatives, two visitors and a health professional about their experience of the care provided. We spoke with eight members of staff including the registered manager, assistant manager, senior care workers, care workers, chef and maintenance person. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records, medication records, and fluid monitoring charts. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at the business plan and health and safety reports. We spoke with another relative and gained feedback from four social care professionals and an activities organiser, who have visited the service.
Updated
28 November 2019
About the service
Dovercourt House Residential Care Home is an adapted building which provides personal and accommodation for up to 27 older people, including those living with dementia. There were 18 people living in the service at the time of our inspection, including people staying on a short break ‘respite’ basis.
People’s experience of using this service and what we found
The quality of the service had improved. Four changes of registered manager in as many years had led to a period of instability in the service, which is only now being addressed.
People, their relatives and visiting professionals spoke about the improvements they had seen following the appointment of their current registered manager. One professional, linked to their previous experience of the service, told us they hoped the leadership, “Manages to maintain it.”
The provider had systems for assessing and monitoring the service to ensure people are consistently supported in a safe, clean and well-maintained. However, they were not robust enough to promptly identify shortfalls and address them, or take effective action when given feedback from health and safety specialists. We have made a recommendation that the service improve in this area.
The registered manager is in charge of the day to day running of the service and supported by the provider through regular telephone contact and visits. However, we continued to receive comments from staff and relatives who felt the provider could be more visible. We have made a recommendation that the service improve in this area.
Despite there being a high turnover of staff, relatives said it had not impacted on people’s care, and were happy with the new staff being appointed. They had confidence in the management and staff to provide safe care and keep them updated on any issues. Describing them as being helpful and friendly, which made people’s visitors feel welcomed.
People were being supported to take their medicines as prescribed and have access to health care professionals when needed. People and their relatives were happy to see the return to ‘home cooked meals’, which offered more flexibility and choice.
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. People’s privacy and dignity were being respected.
People’s care needs were assessed and planned for. Improvements had been made, and further work planned, to support people to access meaningful activities and build/maintain links with the local community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was requires improvement (published 18 February 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
The service has been rated requires improvement for the last three consecutive inspections. This inspection showed improvements were now being made. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.