Archived: Dentholme

Updated 23 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 took place on 11 December 2018 and was unannounced. The inspection was carried out by an adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using services or caring for a person who uses services. The team were experienced in the care of someone who is living with dementia or who is an older adult.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. This was received in a timely manner and in good detail. We also reviewed the information we held about the service, such as notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law. We also spoke with social workers, health care practitioners and commissioners of care during our regular contact with them. We planned the inspection using this information.

The team met all of the eighteen people in the home on the day and spoke in some depth with ten of them. The team spent time talking with people, the staff and with visitors. We also spent time in shared areas observing the life of the home. We spoke with eight relatives and friends who were visiting the home. We met a visiting health care professional on the day of the inspection.

We read six care files in depth. We also looked at a further four care plans and looked at daily notes related to all these care plans. We looked at charts and other records of things like food and fluids taken. We saw moving and handling plans and risk assessments for other interventions. We also looked at records of medicines and checked on some of the stored medicines kept in the home.

We met the registered manager, three supervisors and eight care staff. We also met two kitchen staff and two of the housekeeping team. We talked with them in small groups or individually. We looked at four staff files which included recruitment, induction, training and development records. We checked on the details of the supervision and appraisal notes on these files. We also saw some evidence to show that matters of a disciplinary nature were suitably managed. We saw rosters for the four weeks prior to our visit.

We had access to records relating to maintenance and to health and safety. We checked on food and fire safety records and we had discussions about some of the registered provider's policies and procedures. We saw records related to quality monitoring.

We walked around all areas of the home and checked on infection control measures, health and safety, catering and housekeeping arrangements.

We received information related to staffing issues and quality audits during and after the inspection. We also had contact with the operations manager some time before the inspection in relation to a staffing issue and to the plans for future activities.

Updated 23 January 2019

This was an unannounced inspection that took place on 11 December 2018. The service was last inspected in May 2016 where there were no breaches in regulation seen and the home was rated as Good. We found at this inspection that the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Dentholme 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.

The care home can accommodate up to thirty eight people across four units, each of which have separate adapted facilities. This home specialises in providing care to people living with dementia. There were eighteen people in residence when we visited. People living in the service are older adults. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training about how to identify any issues and report them promptly. Risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been appropriately vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough care staff by day and night to meet people's needs. There were suitable numbers of ancillary staff employed in the home.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

Medicines were suitably managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries and with community nursing services.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were satisfied with the food provided and we saw suitably prepared meals being served. Simple nutritional planning was in place and special diets catered for appropriately. The registered manager continued to look at arrangements around mealtimes to ensure people had the right kind of support.

We have made a recommendation about the arrangements around supporting people at mealtimes.

The provider had updated and refurbished the building to a good standard in the past. It had suitable adaptations and equipment in place. The house was warm, clean and comfortable on the day we visited.

People were aware of the plans to close the service in 2019 when a new residential home was ready to open. Plans were in place to reassess people's needs and wishes with the support of families and social workers.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. 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.

People who lived in the home told us that the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure that confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. One or two plans needed a little updating so that staff would continue to give care in a planned way.

We have made a recommendation about the need to update care plans prior to people moving to the new home.

Staff could access specialists if people needed communication tools like sign language or braille. There was some signage for people living with dementia.

Staff encouraged people to follow their own interests and hobbies. We saw evidence of regular activities and entertainments in the home.

The service had a comprehensive quality monitoring system in place. People and their families were asked their views in a number of different ways. Quality assurance was used to support future planning.

We had evidence to show that the registered manager and the operations manager were able to deal with concerns or complaints appropriately.

Records were well organised, easy to access and stored securely. Staff had started to archive files in preparation for the move to the new home.