We carried out a review of the data available to us about Doneraile Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Doneraile Residential Care Home, you can give feedback on this service.
Doneraile is a care home that provides personal care for up to 24 predominantly older people. At the time of the inspection 22 people were living at the service. Some of these people were living with dementia.
People’s experience of using this service and what we found
Management and staff had a strong set of values which focused on supporting people in line with their preferences and needs. They knew people well and ensured their care was delivered in a way which achieved good outcomes and enabled people to live their lives as they wished. People were treated as individuals and staff had a good understanding of their backgrounds, personal likes and dislikes and health needs.
The provider had acted on a recommendation made at the last inspection about the developing and recording of person-centred care plans to enable individualised care for people. At this inspection we found improvements had been made. Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified and staff had guidance to help them support people to reduce the risk of avoidable harm.
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.
People and their relatives told us they considered the service to be safe and people’s health needs were met. Any changes in people’s health were escalated to the relevant professional and relatives were kept informed.
Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction and activity with staff. Staff knew how to keep people safe from harm. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.
The premises were clean and well maintained. People had access to equipment where needed. The gardens were accessible and there was garden furniture for people to use in the summer. Activities were provided and people were encouraged to take part in various social events, both in and outside of the home.
People were involved in meal planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices.
People and their families were given information about how to complain and details of the complaints procedure were displayed at the service. People, their relatives and staff told us the providers were approachable and listened when any concerns or ideas were raised.
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 good. (Report published on 18 July 2017). At the last inspection we made a recommendation. At this inspection we found improvements had been made and the rating has remained good.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
The service is required to have a registered manager and at the time of our inspection 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 and associated Regulations about how the service is run. The registered manager was also one of the registered providers.
We carried out this inspection on the 17 June 2017. The inspection was announced 24 hours before it took place. This was because the inspection took place on a Saturday and we wanted to be sure someone would be available who had access to all the information we needed.
People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. A member of staff commented; “It’s a lovely, lovely home.” When people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner.
Staff had a good understanding of the underlying principles of the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). People were able to make everyday choices about how and where they spent their time. 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. Mental capacity assessments had been completed to document if people were unable to make decisions for themselves. Best interest decisions were regularly reviewed to ascertain these were still relevant and appropriate.
There were sufficient numbers of suitably qualified staff on duty and the staff team were well supported by the management team and senior care assistants. Staff completed a thorough recruitment process to help ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.
The layout of some areas of the building did not always promote privacy and dignity. The assistant manager told us they would take steps to address this and help ensure people’s dignity was protected at all times. Following the inspection the nominated individual contacted us to explain how staff handovers were arranged to help ensure people's confidential information was protected.
People received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard. Some handwritten entries had not been double signed to safeguard against errors being made.
Staff supported people to access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians. Visitors told us staff always kept them informed if their relative was unwell or a doctor was called.
People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Doneraile. Descriptions of the care and support people needed lacked detail. We have made a recommendation about the recording of people’s care needs.
There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. One member of staff commented, “If I had any concerns [name of nominated individual] would address it.” People and visitors all described the management of the home as open and approachable. One visitor said, “I’m kept informed of any accidents and can drop in at any time.”
People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.
Doneraile Residential Care Home is a care home in Newton Abbot that provides personal care for up to 25 older people and is operated by Doneraile Residential Care Home Ltd. There were 22 people living there at the time of our inspection.
One of the registered providers also held the position of the home’s registered manager. 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.
This inspection took place on 13 July 2015 and was unannounced. This was the home’s first inspection since change of ownership to Doneraile Residential Care Home Ltd.
People told us they felt safe at Doneraile: one person said, “of course I feel safe - I wouldn’t be here otherwise” and another person said “yes, I couldn’t think of anywhere better.”
Staff had received training in safeguarding adults and there was clear information available on what to do in case of a concern. Staff understood about people’s rights to make decisions and felt confident that if they had any concerns these would be acted upon.
People said there were enough staff on duty to meet their needs and spoke highly of the care they received. The staff were described as “excellent” and “brilliant.” At the time of the inspection, there were five care staff on duty, one cook, two housekeeping staff and both registered providers. Staff confirmed this was usual and that staffing levels had been increased in response to people’s changing care needs. This gave staff the time they needed to meet people’s needs in an unhurried manner. The registered providers told us they did not wish to see the quality of the care or the safety of people compromised due to people’s changing care needs. Staff said they enjoyed working at the home, saying it felt like an extended family. Robust recruitment procedures were in place to ensure suitable staff were employed.
Care plans showed each person had been assessed before they moved into the home and any potential risks were identified. Where risks were identified there were detailed measures in place to reduce these where possible. Where necessary staff had consulted with healthcare professionals for guidance on how to support people safely. Care files included a summary of people’s care needs and more detailed information where specific care needs had been identified.
People told us they liked the food and had a good choice available to them. Comments included, “the food is very good” and “the food is lovely with lots of choice.” People confirmed they were able to continue with their interests and hobbies and were free to come and go from the home as they pleased. The registered providers told us they encouraged people to try new activities and to have a fulfilling life.
We observed medicines being administered and this was done safely and unhurriedly. Medicines were stored safely and only senior staff and the registered providers had responsibility for checking stocks, reordering and returning medicines to the pharmacy.
Staff had received training in, and had a good understanding of, the Mental Capacity Act 2005 and the presumption that people could make decisions about their care and treatment. Staff also received training in topics relating to people’s care needs such as skin care and pressure ulcer prevention, diabetes and dementia care and were knowledgeable about people’s care needs.
Staff confirmed there were clear lines of responsibility within the management structure and they knew who they needed to go to, to get the help and support they required. They described themselves as a “happy” team. They said they had a very good relationship with the registered providers who were always available if needed.
Doneraile had been voted the third best care home in the South West for 2015 by www.carehome.co.uk as a result of the comments received from people’s relatives. Prior to this inspection, we had received information from a relative about the quality of the care provided at the home. They told us their relative “loved the service and the carers that worked there”. They said registered providers “ran the service beautifully” and they “could not be happier with the care, food and entertainment.”
There was a policy in place for dealing with any concerns or complaints and this was made available to people and their families. People said they would speak with the registered providers if they had any concerns or make a complaint but they had not needed to as they were happy with the care and support they received.
The registered providers were committed to providing a high quality service to people and there were thorough systems in place for managing information relating to the running of the home. The registered providers undertook regular health and safety audits to ensure people’s safety and that of the environment was well maintained and suited to the people living in the home
The home was found to be clean and well maintained with no unpleasant odours in any of the communal areas. Two rooms were currently vacant and these were in the process of being redecorated to a high standard with new carpets laid. A passenger lift and a stair lift provided access to the first floor; however the passenger lift was not working on the day of the inspection. Following the inspection the home confirmed the lift had been repaired and was working.