Dovehaven Lodge

Dovehaven Lodge is a residential home providing personal and nursing care for up to112 people. In 4 separate single story units with enclosed gardens. One unit provided specialist support for male residents only. At the time of inspection there were 99 people living in the home.

People's experience of using this service and what we found

People had not always been supported by enough suitably trained staff. Staff deployed to support people who may present a risk to themselves or others had not received suitable training. However, the training had been planned and the provider was negotiating with commissioners to ensure information about people's needs was accurate prior to admission. We have made a recommendation about this in the safe domain of this report.

People were supported by staff who understood and followed the providers' safeguarding policies and procedures. Relatives praised the quality of the staff and were confident their relations were safe.

People were supported to manage risks in their daily lives because the provider had an effective system in place to analyse incidents and minimise the risk of reoccurrence.

People's relatives and staff had mixed views about how well the service was managed. On the male only unit, relatives and staff felt very confident the management of the service was good. On other units some relatives and staff felt management could be improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good, (Published 4 November 2022). At this inspection this has remained the same.

Why we inspected

We received concerns in relation to staffing and the quality of care. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Recommendations

We have made a recommendation in relation to staffing.

We found evidence the provider needed to improve. Please see the safe domain of this report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dovehaven Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Dovehaven Lodge is a residential home providing personal and nursing care for up to112 people. At the time of inspection there were 93 people living in the home. There are four separate single storey units and a secure garden area.

People’s experience of using this service and what we found

The management of medicines and their administration ensured people received their medicines safely. However, we found one example of covert medicines being administered differently to the agreed method. We have made a recommendation about covert medicines in the safe key question below.

Risk management and safeguarding procedures helped to keep people safe. One relative we spoke with felt concerned about safety; this was being addressed by the provider. Other relatives said they were confident people were safe in the home.

People were supported by enough staff who had been recruited properly. Staff felt there were times when they were very busy. The provider had relied on agency staff to maintain staffing levels. Recruitment was an ongoing challenge which the provider was addressing robustly.

People's safety needs were reviewed regularly to minimise the risks of harm because the provider analysed incidents and applied lessons learned.

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.

The management and oversight of the service was thorough. Regular audits of care practice, care records and the premises helped ensure the providers quality aims were embedded and understood by staff.

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 16 September 2021) and there was a breach 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 the regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16 September 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We carried out this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dovehaven Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice

Staff followed good practice in relation to the use of personal protective equipment (PPE). Stocks of PPE were available throughout the home to help ensure staff could maintain their good practice.

The home was clean. Housekeeping staff maintained effective routines with increased cleaning of all touchpoints to minimise the risk of infection and cross contamination through the home.

The provider ensured the registered manager and staff were up to date with the most recent government guidance in relation to visitors. People continued to have visitors. The processes visitors needed to follow had been communicated and updated by the home when guidance changed.

Dovehaven Lodge is a residential care home providing accommodation for up to 112 adults who require assistance with personal or nursing care needs. The home accommodates people across four separate units, each of which has separate adapted facilities. Two of the units specialise in providing care for people living with dementia. The home is purpose-built and located in Ingol near Preston, Lancashire.

People’s experience of using this service and what we found

There had been recent changes to the management and staff team and the COVID-19 pandemic had impacted on staff absence. This had resulted in the home operating without a registered manager and the provider supporting the home with representatives from their senior management team (referred to in the report as 'senior managers').

Some staff members said management uncertainty and the use of agency staff had created a degree of instability in the home. Some staff members told us this situation had improved following the provider's involvement and presence of senior representatives. We noted permanent staff were being recruited with further recruitment ongoing during the inspection. We found sufficient numbers of staff deployed to meet people's needs and ensure their safety.

The provider's quality assurance systems, audits and action plans were not always sufficiently robust or embedded into the service as we found shortfalls around care planning and record keeping. This could put people at risk of not receiving proper and safe care. The senior management team were aware of the shortfalls and was taking appropriate action to improve the situation. Although we noted recent input and improvements as a result of these actions, this has led to a breach of the regulations that can be seen in the 'Safe' section of the report.

Medicine's practices and administration needed to be improved. Although the provider was in the process of improving documentation around medicines, this and other medicine's issues were a breach of the regulations. This can be seen in the 'Safe' section of the report.

Some areas of incident reporting needed improving and this had resulted in CQC being unable to take regulatory action in a timely way. The provider was aware of these issues and had cooperated with us and the local authority around these matters prior to the inspection.

Most people's care records were well written and person centred. They provided staff with clear guidance about people's needs whilst some others were not sufficiently detailed. This could result in people not receiving the care and support they needed. These issues were corrected during the inspection.

People's care was tailored to their needs, routines and preferences and staff knew people well. People had access to organised activities. We did note improvements were required in this area and have made a recommendation about this in the 'Responsive' section of this report.

People told us they felt safe and were happy with the service they received. They said staff were kind and caring and they were treated well. Staff understood how to protect people from abuse and recruitment processes ensured new staff were suitable.

Staff had been trained and had their competency checked. Specialist training was available should staff and managers require it. Infection control was well managed, and the home was clean and free from hazards. The environment had been developed with people’s specialised needs in mind.

Safe visiting processes were in place to ensure people could see their visitors when they wished and could maintain relationships that were important to them. People we spoke with, supported they had confidence in raising any issues. Complaints were handled appropriately.

People's care and support needs were assessed prior to them using the service to ensure their needs could be met. They were supported to live healthy lives and had access to health and social care professionals. When people's needs could not be met or where they had progressed and would benefit from increased independence, the provider took appropriate action.

The home worked in partnership with other organisations to provide effective and consistent care. 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.

We observed the senior managers and staff had developed friendly, caring and respectful relationships with people and their families. People were treated as individuals which helped protect their dignity. People's equality and diversity was respected by a caring staff team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 April 2020, and this is the first inspection.

Why we inspected

This was a planned inspection to provide a rating under the Care Act 2014.

We looked at infection prevention and control measures under the 'Safe' key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.