Dudbrook House

Dudbrook Hall is a 73 bedded purpose built residential care home. The service provides accommodation and personal care for older people and people living with dementia. The service is split over 2 floors, with the residential unit on the ground floor and the dementia unit on the first floor. At the time of our inspection there were 43 people using the service.

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

Effective arrangements were in place to ensure recruitment checks on staff were safe. Minor improvements were required to staff recruitment checks. We have made a recommendation about the management of staff recruitment checks.

We received positive feedback about the service. A relative told us, "Staff are excellent. They have genuine concern for the residents' wellbeing. The manager is approachable, and I have no concerns."

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. People were cared for and supported by staff who had received appropriate training. There were systems in place to minimise the risk of infections. There were safe medicine procedures for staff to follow.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way and in their best interests; the policies and systems in the service supported this practice.

Staff understood how to raise concerns and knew what to do to safeguard people.

The provider had monitoring and audit systems to ensure they provided good care and these were kept under regular review.

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 12 January 2018).

Why we inspected

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

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.

Recommendations

We have made recommendations in relation to staff recruitment and risk assessments.

Follow up

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

Dudbrook Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Dudbrook Hall is registered to provide accommodation and personal care to up to 43 people in one building, across two floors. At the time of our inspection there were 42 people living at the service some of whom were living with dementia.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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.

Risks to people had been assessed with guidance in place for staff to manage risk. Staff showed a good awareness of risks to people and knew what to do to keep people safe. Staff had received training in how to safeguard people from abuse and knew the signs to look for and how to report any concerns.

Medicines were managed safely by staff who had been trained and assessed as competent to administer medicines. Good infection control practices were observed and the service was clean and free from odours.

Staff had been recruited safely. There were sufficient staff deployed to safely meet people's needs and preferences.

The service provided excellent support to staff to ensure they had the skills and experience to support people effectively. Good quality training and supervision was in place to monitor staff competence and support staff to develop professionally.

The registered manager was enthusiastic and innovative which resulted in improved outcomes for people who used the service.

People were supported to have enough to eat and drink which met their health needs and preferences. The service supported people to access a range of healthcare professionals to maintain their health and wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and caring, listened to people and provided them with care and support the way they wanted it. People's independence was supported and encouraged. Staff treated people with dignity and respect and people's privacy was respected. Visitors were made welcome at the service which helped people maintain important relationships.

The service treated people as individuals and provided care and support that met their needs and wishes. Staff knew people well and respected people's routines and preferences.

Activities and events were organised which reflected peoples choices and interests. People were asked for their opinion and this used to provide opportunities for meaningful engagement.

People were supported to express their wishes regarding end of life care and these were documented and respected.

There were systems and processes in place to respond to complaints. We saw complaints were investigated thoroughly and were well managed to achieve resolution.

The management team and provider showed a commitment to providing good quality care and seeking ways to continuously improve the service.

The positive values of kindness, empathy, respect and person-centredness were shared by staff and management and were put into practice.

Staff felt well supported by the manager and provider and appreciated their hands-on approach which created a strong sense of teamwork.

People, relatives and staff were all included in the running of the service. Their opinion was actively sought and acted upon to drive improvements.

Dudbrook Hall is residential care home registered to provide accommodation for 43 older people who require personal care. There were 42 people living at the home on the day of our inspection.

The home had a registered manager who had been registered since January 2011. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us they felt safe and well cared for at the service and that staff responded to requests for assistance quickly.

Risks were assessed and monitored safely however improvements were required regarding how risks were recorded to make information easier to find.

Improvements were required in respect of medicine management to ensure that records were accurate and that people received their medicines as prescribed.

Infection control practices required improvement in some areas to protect people from the risk of infection.

Staff understood their responsibilities to protect people from abuse and were aware of the signs to look for and reporting process if they suspected someone was at risk of harm.

There were sufficient numbers of staff who had been recruited safely and had the relevant skills and knowledge to effectively meet people’s needs.

Where people experienced difficulties with decision-making, they were supported appropriately in accordance with current legislation.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken. This ensured that any decisions taken on behalf of people were in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated codes of practice.

A choice of food and drink was available that reflected peoples nutritional needs, and took into account their preferences and any health requirements. However, the dining experience for people required improvement as people experienced delays in receiving meals and did not always have access to the help they required to support them with eating.

People were supported to maintain their health and had regular access to wide range of healthcare professionals.

The home had a warm and friendly atmosphere which people, relatives and staff valued. Staff had positive relationships with people who used the services and knew them well.

Staff knew people well and supported them to with maintaining their independence. People and their relatives told us staff treated them or their relative with kindness and respected their privacy and dignity.

The care and support provided met people's individual needs and preferences. People, or their representatives, where appropriate, were involved in making decisions about their care and support and felt listened to and included.

People were encouraged to follow their interests including religious practices and beliefs and were supported to keep in contact with and maintain positive relationships with their family and friends.

There was a registered manager in post who promoted the organisations values of upholding people’s dignity, treating people with respect and supporting their independence.

Staff enjoyed working at the service and felt that they were included in the running of the home and that their views were valued.

There were systems in place to ensure the quality and safety of the service and to drive improvements and respond appropriately to complaints and feedback.

People and their representatives were involved in how the service was run and their opinions were actively sought through satisfaction surveys and regular meetings.

We looked at the care records for four people who used the service. We found that people's care needs were assessed and monitored and they received care that met their needs.

People were provided with a choice of suitable and nutritious food and drink. We spoke with three people who used the service who confirmed they had plenty to eat and drink and were given choices.

There were arrangements in place to minimise the risk of abuse or harm to people who were using the service.

People were supported by enough staff to meet their needs. We found that the staff team was well organised and effectively led to ensure people who used the service received the care they needed. A relative described the staff as "...excellent", and a person who used the service told us that the staff were "...kind".

The provider had an effective system in place to identify, assess and manage the risks to the health, safety and welfare of people using the service and others. People had opportunities to comment on the service provided and their views were listened to an acted upon.

People we spoke with told us they were happy with the arrangements made for their medicines. People also told us that they were able to make decisions and retain their independence where they wanted to and felt respected at the home.

People were cared for by staff who had had appropriate checks undertaken before they began work. This helped to ensure that only suitable people were employed to care for people who used the service. One person said, 'The staff are lovely, they are very patient with people and treat them so nicely and respectfully.'

People were given clear information on how to raise comments or complaints. People we spoke with felt that the staff and management team were approachable and available. This helped them to feel confident to express their views. One person said, 'I would feel able to say if I was not happy, I could complain. I am sure they would listen to me, but everything is fine.'