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This service was previously managed by a different provider - see old profile

All reports

Inspection report

Date of Inspection: 7 November 2012
Date of Publication: 8 December 2012
Inspection Report published 8 December 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 7 November 2012, observed how people were being cared for and talked with people who use the service. We talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

Darley Court provided intermediate care and treatment for patients who had been transferred from hospital for a short term period, which did not normally, not exceed 6 weeks. This was to enable patients to be discharged home or into social care. Patients were transferred with copies of all notes and documentation of the care delivered whilst in hospital.

Care was provided in a clean and organised environment. There were 3 separate units, Mere Hall, Queens Park and Barlow Park, each with 10 bedrooms.

During the inspection we sampled 10 care records. We found them to be patient centred with individualised care plans that were written from the person's point of view. We saw that assessments were reviewed weekly or as changes occurred. We saw a staff signature sheet in the front of all care files to identify all staff involved in the care of each patient.

Risk assessments for falls, nutrition and mobility had been undertaken. When falls had occurred we found that these had been appropriately investigated, recorded and the risk assessments reviewed to reduce the risk of reoccurrence.

We had received some information of concern in relation to the care and welfare provided at Darley Court. We had been informed that patients were left for long periods alone and that some patients were unable to use the call bells to alert staff when needed.

We observed during the time spent on the inspection that when patients were nursed in their rooms, call bells were left in easy reach. We saw one patient having medication through a nebuliser whilst resting on the bed; we saw staff checking this person at regular intervals. None of the patients we spoke with told us that there had been any issues with staff not responding in a timely manner. One person said: “Sometimes at night you might have to wait, if they are busy in someone’s room, but generally it’s not a problem”.

We found appropriate and timely escalation and referral to medical staff and other health professionals such as speech and language therapists or dieticians when required. The information documented in daily records was detailed and all entries were timed, dated and signed. This gave a clear picture of day to day events. We saw that fluid and food charts were accurately completed and that patients were weighed weekly.

We saw the use of a do not attempt resuscitation (DNAR) form where the Doctor had completed as required. The Doctor had ticked to record that he had discussed the decision with the next of kin. We were told that a discussion had taken place with family members but the content of the discussion not recorded. We have since been informed that this has now been documented, and will be recorded in any future DNAR in the unit.

“Therapy goals” to support returning to good or improved health were agreed with each patient. These provided clear and achievable targets with timescales for achievement. Display boards were being trialled on one unit and target goals were written on these, giving direct information for relatives.

We saw evidence of the use of a medication review form with actions identified when medication be changed or discontinued.

We saw evidence of multi disciplinary meetings were various health care professionals were involved in continued care and treatment. These included occupational therapist, physiotherapist and dieticians, along with medical and nursing staff. We saw that individual assessments by each professional were detailed and patient centred.

We observed patients being transferred safely from wheel chairs to arm chairs and into beds. When equipment was used, this was used as recommended.

We spoke with 4 patients who told us “The nurses look after me well, I have no complaints”, “I hope to be going home soon but whilst I have been here I have been well looked after” and “I have been here for about a week now, its been fine, the nurses are doing a good job”.