All inspections: Derwent Lodge Care Centre

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. During the last inspection on 18 March 2014 the provider was meeting the regulations we checked.

Derwent Lodge Care Centre is registered to provide nursing care to a maximum of 62 people with nursing care needs and/or dementia care needs, and those with physical disabilities. The service is arranged over three floors in single bedroom accommodation. At the time of inspection there were 54 people living at the service.

The registered manager has been in post since November 2011. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives were happy with the care provided and told us they felt safe and staff treated them with dignity and respect. People and their relatives were involved with the planning and review of their care, so their preferences and wishes were known.

The service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Concerns were raised by people, relatives and staff about the service being short of staff on occasions, leading to delays in care being provided. Staff felt they were not kept informed about any action being taken to address this. The manager and deputy manager said there was ongoing recruitment of new staff taking place to address shortages.

We identified some shortfalls in the standard of records keeping particularly for risk management and wound care. This could place people at risk of not receiving the care and treatment they needed.

Staff understood safeguarding and whistleblowing procedures and knew to report concerns to the manager. Records we saw confirmed the provider followed recruitment and training procedures. Staff demonstrated an understanding of people’s individual needs and wishes and how to meet them.

Systems were in place to monitor the quality of the service, however these were not always effective in identifying shortfalls, for example, with care records. People and relatives said they would express any concerns they might have, so these could be addressed.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with three people using the service, the manager, a relief manager appointed to support the manager and the provider's regional Manager. People told us they were generally happy with the care they received. One person said 'I am well looked after.' A second person told us 'I don't get out as much as I like and not all the activities are suitable for me but overall I get the care I need.'

We found the provider had taken action following our last visit to improve the recording of people's care and the management of medicines.

We spoke with eight people using the service, six relatives and twelve staff.

People and the majority of relatives expressed satisfaction with the care being received. One person said, 'They (the staff) are wonderful, nothing is too much trouble.' One relative said, 'I couldn't have asked for a better outcome or home' and another, 'they (the staff) are very nice and friendly'. We did receive some concerns from a relative and these were brought to the attention of the manager, with the person's permission.

We found one care need that was not being met and brought this to the attention of the manager so it could be addressed. Some of the care records did not accurately reflect people's current needs and we have asked the provider to make improvements.

The arrangements for the management of medicines were not always effective in protecting people against the risk associated with medicines. Receipts of medicines were not always recorded to provide a full audit trail.

The provider had in place effective recruitment and selection processes, and these were being followed.

Staff said they received training to provide them with the skills and knowledge to care for people effectively.

Systems were in place for monitoring the service and were being followed, so the provider was aware of the areas in need of improvement within the home and would keep them under review.

During our visit we spoke with eight people who use the service, seven care staff, three qualified nurses, and a regional manager who was covering for the home manager.

People told us that they were satisfied with the care they were given and staff were always available to support and care for them. The general feedback given by people was that the home took care of their needs, they felt well cared for and the atmosphere was very friendly. One person told us 'the girls (staff) are lovely, I can not fault them, they work hard to make sure we are alright'. People confirmed that staff respected them at all times and they were able to make choices and were supported to access other services to ensure that their health needs were well cared for.

The environment of the home was maintained and people were cared for in a clean hygienic environment. People had consented to receiving care and treatment and where they lacked capacity best interest meetings were held.

We found that there were enough qualified and skilled staff to meet people's needs. The provider gave people using the service sufficient information for them to make complaints if they ever needed to, and complaints were investigated fully.

People said the staff treated them with respect and listened to what they had to say. Visitors told us they had been able to visit the home on behalf of their relative to see if it was somewhere they would like to live. People said that they and their relatives had been asked about their care needs and wishes. Visitors who were also people's representatives confirmed they had been involved in the plan of care for their relative. People told us they were able to make choices, for example with meals and getting involved in activities, and that these choices were respected.

People said staff looked after them well and one said the staff 'could not be better'. Visitors expressed satisfaction with the care their relatives were receiving and said they were informed if there were any changes in their relative's condition. One person told us the home 'could not do more and the staff are absolutely wonderful.' People said staff responded promptly when they rang the call bell, and if they could not assist them immediately staff explained this and returned as soon as they were able. Visitors told us the staff arranged for their relative to be seen by healthcare professionals when needed.

People said they felt safe with the staff and visitors agreed with this. People and their visitors told us they would raise any issues with the manager and were confident they would be addressed. People said there were enough staff on duty to meet their needs. Visitors explained they visited at different times of day and felt the numbers of staff on duty were always appropriate to meet people's needs. People said staff knew how to care for them. Visitors told us they had been involved in relatives meetings and had been able to express their opinions, which were listened to.

Archived: Derwent Lodge Care Centre

All Inspections

22 July 2014

During a routine inspection

18 March 2014

During an inspection looking at part of the service

1 October 2013

During a routine inspection

15 February 2013

During a routine inspection

21 February 2012

During a routine inspection