Dundoran Nursing and Residential Home

Updated 5 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Dundoran Nursing and Residential Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Dundoran Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection the there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since our last inspection and we sought feedback from the local authority and local safeguarding team. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed staffing levels and walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with 2 people who used the service and 9 family members about their experience of the care provided. We spoke with 11 members of staff including the registered manager, clinical lead, nurses, care staff, maintenance staff and catering staff. We looked at a range of records. These included 5 people's records related to their care and support and a variety of people's medicine administration records.

We looked at recruitment records for 3 staff members employed since the last inspection. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 5 September 2023

About the service

Dundoran Nursing and Residential Home provides accommodation for up to 39 people who need help with nursing or personal care. At the time of the inspection 21 people were using the service. The majority of people living in the home, lived with dementia or other mental health needs.

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

During the previous inspection we identified serious concerns with the safety and quality of the service being provided for people.

During this inspection the provider had made improvements, however more time was required for these improvements to be sustained over a longer period of time.

Monitoring records were not always up to date and did not show people received the care they needed with regards diet and fluids. We have made a recommendation about this.

Monitoring to mitigate risks had improved . Care records were individualised and reflected each person's needs and preferences. Risks were assessed and identified, and staff had guidance to help reduce the risk of avoidable harm to people they were supporting.

Medicines management had improved and people had their medicines as prescribed. Staff had received training on administering medicines and their competence was regularly checked.

The principles of the Mental Capacity Act (2005) were now being consistently followed when providing care and treatment for people. 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.

Staff were knowledgeable about people's health needs and the provider worked in partnership with other health professionals as a measure of providing the appropriate level of support.

The provider had addressed issues identified from the last inspection and internal quality assurance audits relating to the medicine's, environment, care records and consent had improved.

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 inadequate (published 29 June 2023). 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 that the provider had made some improvements to the service and they were no longer in breach of regulations.

Exiting special measures

This service has been in Special Measures since 29 June 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Recommendations

We have made recommendations about the systems in place for the monitoring of peoples diet and fluids.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 inspections, by selecting the 'all reports' link for Dundoran Nursing and Residential Home 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.