The Care Quality Commission
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Archived: Dunster Lodge Residential Home

Overall: Requires improvement read more about inspection ratings

Manor Road, Alcombe, Minehead, Somerset, TA24 6EW (01643) 703007

Provided and run by:
Ms Margaret Joan Hayes

Important: The provider of this service changed. See new profile
Important: The provider of this service changed - see old profile

All Inspections

14 May 2015

During a routine inspection

This inspection was unannounced and took place on 14 May 2015.

Dunster Lodge Residential Home is registered to provide accommodation and personal care to up to 19 people. The home specialises in the care of older people. At the time of this inspection there were 15 people living at the home.

The last inspection of the home was carried out 22 July 2014. No concerns were identified with the care being provided to people at that inspection.

The registered provider took an active role in the running of the home. 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.

A new manager had started work in the home the week before this inspection took place. They had been able to shadow the previous manager for a week to get to know the home and provide continuity for people and staff.

We found that improvements were needed to make sure accurate records were kept. Records did not always give up to date information about the care people required or how decisions had been made when people were unable to make a decision for themselves. We have made a recommendation about supporting people who lack the mental capacity to make decisions.

Improvements were also needed to make sure there was an effective system in place to monitor the quality of the service provided and plan on-going improvements.

The registered provider and new manager told us their vision was to create a homely environment where people felt safe and well cared for. Staff were aware of this ethos and were committed to providing a service in line with it.

There were enough staff to meet people’s needs safely. People told us staff took time to support them with their care and they never felt rushed. One person told us “They are very busy but you never feel they are rushing you along.”

There was a robust recruitment procedure which made sure new staff were thoroughly checked and minimised the risks of abuse to people. Staff had opportunities to attend training which made sure they had up to date skills and knowledge to effectively support people.

There was a stable staff team at the home who knew people well. People said staff were kind and caring and they felt safe with the staff who supported them. People were able to make choices about all aspects of their day to day lives and could continue with their own personal routines. One person told us “You can do what you like here. I have my own little routines, they work around me.”

Each person had a single room which they had been able to personalise to their needs and tastes. People’s privacy was respected by staff. Visitors were made welcome and people were able to spend time with personal and professional visitors in communal areas or their personal rooms.

People’s nutritional needs were assessed to make sure they received a diet in line with their needs and wishes. People were able to choose where they ate their meals. There was no choice of main meal but people were complimentary about the food. Comments included; “I like the food” and “You don’t get a choice of food but it’s usually pretty good so it doesn’t matter.”

People had access to health care professionals according to their individual needs. Staff arranged for people to see appropriate healthcare professionals and assisted people to attend appointments outside the home. One person commented “They got the doctor when I was poorly. They didn’t hesitate so I got seen quickly.”

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

22 July 2014

During a routine inspection

An adult social care inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

People who lived in the home said they felt safe and they were treated kindly. One person said "Oh yes, of course we are safe here. People are very kind.' Another person told us they had chosen to live in the home because of the beautiful environment but was happy there because the staff were kind. 'Nothing is too much of a problem.'

People and staff told us they knew how to report any concerns. They said they would report any issues to the manager in the first instance. Staff knew which external authorities they could go to if necessary.

The service identified, assessed and managed risks to the health, safety and welfare of people. People's care plans contained individual risk assessments and plans to minimise these risks. Staff carried out regular in-house checks of the environment, fire safety systems and other risk areas. Specialist contractors were employed to check and maintain essential safety protection systems and other equipment.

Arrangements were in place to deal with foreseeable emergencies. We saw records of regular fire drills and an emergency evacuation plan. Staff said they received first aid training and would not hesitate to call the emergency services or the local GP practice as and when needed.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager said they had made a Deprivation of Liberty application and we saw the records confirming this had been completed appropriately.

Is the service effective?

People were supported to live their lives in a way that suited their personal needs and preferences. This helped promote effective care outcomes and a good quality of life for the people who lived in the home. People told us they were happy with the care and support they received. One person said "I have been well looked after since the day I arrived.'

Care plans and discussions with people who lived in the home showed people's care needs had been assessed and appropriate support was provided. Staff we spoke with had a clear understanding of each person's individual support needs and how they should be met. There were enough qualified, skilled and experienced staff to meet people's needs. People also had access to more specialist staff when needed.

People were supported in promoting their independence and community involvement. We heard people went to local clubs and visited the local community in a variety of ways.

Is the service caring?

We observed staff treated each individual with dignity and respect. They spoke to people in a friendly and caring manner and addressed people by their preferred names.

Staff respected people's privacy and did not enter people's rooms without knocking and asking their permission to enter. People were given space to spend time on their own but staff were on hand whenever needed.

Staff supported people to make their own daily living choices and to be as independent as they were able to be. This helped promote people's self-esteem and gave them a sense of achievement.

We observed people's rooms contained individualised furnishings and personal belongings. This helped people feel more at home and ensured their rooms were individualised to suit each person's tastes.

Is the service responsive?

The service was responsive to people's needs. People's needs were assessed and their care was planned and delivered in line with their individual needs and personal preferences. Staff had a clear understanding of each person's support needs and how they should be met. For example, one person had begun losing weight. Following assessments the manager had arranged for them to have new dentures and they had responded well.

People told us they were involved in making decisions about all aspects of their care. Although one main meal choice was offered at lunch time people were consulted about menu choices and were free to have their own alternative meal if they wished. We heard the chef visited people individually and asked about their likes and dislikes.

People could choose where and how to spend their time. They were free to move around the home and the grounds as they wished. They could choose to spend time on their own in their rooms or chat with each other or the staff in the various communal areas.

The manager organised meetings for people to have their say about the service. They also had regular conversations with each individual and their close family members about the person's choices and preferences. This helped ensure the care and support provided remained appropriate to the individual's needs.

Is the service well led?

This established home was re-registered in December 2013. The provider was one member of the previous partnership. The provider was registered with the Care Quality Commission as the nominated individual and was closely involved in the daily running of the home. There was a registered manager for the service.

The manager monitored the quality of service daily through personal contact with people and their families. People said they could talk to the manager or staff if they had any problems and they would always try to resolve them. We observed the manager had a good rapport with each of the people living in the home.

There was a clear staffing structure in place with clear lines of reporting and accountability. There was a stable small team of care staff who all worked well together. They were able to report any issues directly to the manager and were confident appropriate action would be taken.