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Archived: Durham Care Homes Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 27 April 2019

About the service: Durham Care Homes is a residential care home for up to 20 people. At the time of the inspection, it was providing personal care to 14 people aged 65 and over.

People’s experience of using this service: The quality of care had deteriorated since the last inspection. People’s safety had been placed at risk due to safeguarding policies and procedures not being followed. The provider and manager had not assessed and managed risk, which placed people at risk of harm. Some people had not received their medicines as prescribed. Staff recruitment continued to be poor. There was insufficient staff to meet people’s needs. There were concerns with staff practices regarding infection prevention and control.

Some people’s nutritional and hydration needs had not been fully assessed and met; the meals provided were repetitive and gave limited choice to people. The meals and snacks for people on soft diets were inadequate. Staff contacted health professionals when required, although during the inspection, staff had to be prompted on two occasions to seek medical assessment for people.

Staff did not have the right skills, experience and knowledge to care for people safely. There was partial understanding from the manager regarding mental capacity legislation, the need for people’s deprivation of liberty (DoLS) to be authorised and the need for people to consent to their care. However, some people’s DoLS had expired and applications had not been resubmitted. Three people met the criteria for DoLS but applications had not been made to the local authority for authorisation.

We observed episodes of care and staff interaction with people and each other that was poor and required improvement. There were also some interactions between staff and people who used the service that was kind and considerate. There were times when people’s privacy and dignity were compromised. There was very little social stimulation provided to people, especially those people who remained in their bedrooms.

People had assessments and plans regarding their care and support needs. However, the care plans lacked important information, were not always kept up to date when changes occurred and had limited direction for staff in how to deliver care in a person-centred way.

The service was not well-led and there continued to be a lack of effective governance and oversight by the provider and manager. The day to day shifts lacked organisation and the culture in the service required significant improvement; there was institutional and unsafe practices, which went unnoticed and unchecked by management. Records were not always accurate and up to date.

More information is in the full report.

Rating at last inspection: Requires improvement; published 19 February 2019.

Why we inspected: We received information from the local authority regarding an escalation of concerns about the service; they had been completing monitoring visits. We completed this inspection based on these concerns. At the time of the inspection, we were aware of incidents being investigated by another agency.

Enforcement: The service met the characteristics of Inadequate in four key questions of safe, effective, responsive and well-led and Requires Improvement in caring. We are taking enforcement action and will report on this when it is completed.

Follow up: We will continue to monitor the service closely and discuss ongoing concerns with the local authority.

The overall rating for this registered provider is 'Inadequate'. This means that it has been placed into 'Special Measures' by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care

Inspection areas

Safe

Inadequate

Updated 27 April 2019

The service was not safe.

Details are in our safe findings below.

Effective

Inadequate

Updated 27 April 2019

The service was not effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 27 April 2019

The service was not always caring

Details are in our caring findings below.

Responsive

Inadequate

Updated 27 April 2019

The service was not responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 27 April 2019

The service was not well-led.

Details are in our well-led findings below.