Archived: Darwin Court Care Centre

Updated 7 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection visit took place on 16 and 17 March 2016 and was unannounced. The inspection team consisted of three inspectors, a specialist advisor and two experts by experience. A specialist advisor is a person who has professional experience in a particular area of work. This specialist advisor was a registered mental health nurse who had experience of working with older adults and people living with dementia. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was with older people and people living with dementia.

We had asked the provider to send us a Provider Information Return (PIR) but due to technical difficulties beyond the provider’s control, and despite them trying to rectify matters, this had not been received prior to our visit. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant. We reviewed other information we held about the service. We looked at information received from people that used the service and the statutory notifications the provider had sent us. A statutory notification is information about important events which the provider is required to send to us by law.

We spoke with 25 people who used the service and 21 relatives and friends. We also observed the care people received in the communal areas of the home so we could understand people's experience of living there. We also spoke with 15 members of care staff, the manager and regional manager.

Some of the people living at the home were not able to tell us, in detail, about how they were cared for and supported because of their complex needs. However, we used the short observational framework tool (SOFI) to help us to assess if people’s needs were met and they experienced good standards of care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at 16 people’s care records to see if they were accurate and up to date. We reviewed three staff files to see how staff were recruited. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 7 June 2016

We inspected this service on 16 and 17 March 2016. This was an unannounced inspection and was the first inspection under the new provider who registered with us in March 2015. Darwin Court Care Centre provides accommodation and support for up to 112 people. On the days of our inspection there were 86 people using the service. The service is divided into six units across three floors. Some of the people living there had nursing care needs, and some were living with dementia.

The home had a manager in place who was in the process of registering with us. 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.

We found that people did not consistently receive support from staff who knew them well and staff were not always aware of some people’s support needs. Consent to care was not always sought in line with legislation and guidance. Some people did not have the capacity to make certain decisions, and it was not always clear how decisions had been made in their best interest or who had been consulted.

We found that people were not always cared for in a dignified, compassionate way, and there were times when their privacy was not respected. There was a lack of consistency in involving people with decisions and the planning of their care.

People did not consistently receive care that was individual to them and responsive to their needs. Opportunities for people to follow their interests and engage in activities varied.

There was a lack of consistency in the leadership and management across the units, and people told us that the quality of the staff varied. Care records were not always up to date and accurate and this made it difficult for staff to be clear about people’s support needs.

People told us they felt safe living there and staff understood how to protect people from harm and abuse. Risks were managed and there were sufficient staff to keep people safe. Medicines were managed so people received them safely and as prescribed. People were supported to maintain a balanced diet and have access to healthcare services when needed.

People told us and we observed that some staff were kind, caring and compassionate. We also saw that some staff responded well to people’s needs and engaged positively with them. People knew how to raise any concerns or complaints and we saw that the provider had addressed complaints in a timely manner.

Staff told us that the availability of training had increased and the quality of the induction had improved. Some staff had received supervision sessions and we saw that this had been planned for others.

We saw that the provider had implemented some changes since the manager had been appointed. A recruitment drive was in progress to increase the numbers of permanent staff; work was in progress to improve the quality of the care records; regular quality audits had been introduced; and opportunities for people to share their experiences had been implemented.

You can see what action we told the provider to take at the back of the full version of the report.