Dauntsey House

Updated 1 December 2022

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 carried out by one inspector 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

Dauntsey House 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. Dauntsey House is a care home without 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 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 the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people and one relative about their experience of the care provided. We spoke with one visiting professional and five members of staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed four people’s care records, multiple medicines records, incidents and accident recording, safeguarding records and health and safety records.

After the inspection

We continued to validate evidence found during the inspection. This included speaking with seven relatives and a further two members of staff on the telephone. We also spoke with the nominated individual on the telephone. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed health and safety records, quality monitoring, behaviour support plans, recruitment information, policies and procedures and the service improvement plan.

Updated 1 December 2022

About the service

Dauntsey House is a residential care home providing accommodation and personal care to up to 21 people. The service provides support to adults over 65 years and people living with dementia. At the time of our inspection there were 21 people using the service.

Accommodation is provided on three floors accessed by stairs and a lift. People had their own rooms and access to communal bathrooms, lounge and dining room. There were enclosed, secure gardens accessed on the ground floor.

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

People’s medicines were not always being managed safely. Whilst staff received training on administering medicines, we found they were not always following the provider’s medicines management policy.

Risks to people’s safety were not being managed robustly which put people at risk of harm. Incidents between people living at the service had not always been reported appropriately to the local authority safeguarding team. It was not clear what action had been taken in response to incidents to mitigate risks and prevent reoccurrence.

Staff had not been recruited safely. The required pre-employment checks had not been carried out. The registered manager took immediate action to address this.

A new registered manager had started prior to our inspection. They had identified some shortfalls such as poor incident management and had taken steps to carry out improvements. However, quality monitoring and governance systems at the service were not robust or effective and had not identified shortfalls found during this inspection.

Systems were not in place or established to continually monitor practice and make sure staff were working safely. Systems had not identified shortfalls in people’s records or shortfalls in staff recruitment records to make sure the provider had accurate oversight of the service.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People and relatives all told us they were happy living at the service. Despite the shortfalls people appreciated the staff approach and told us there were enough of them. Relatives were able to visit, and we observed family members visiting people during our inspection.

Staff wore personal protective equipment and there was stock available around the service. Staff had received training on infection prevention and control and guidance was in place to work safely. Posters were up on walls at the service to demonstrate good hand washing techniques and to give guidance on COVID-19.

The home was clean, and people told us they were happy with the cleanliness of their rooms. We identified two areas which required repair which we shared with the provider. They told us they would take action to address the concern.

Staff had training on safeguarding and told us they would not hesitate to report any concerns. Staff were able to have meetings to discuss ideas or share concerns. Staff told us the new registered manager was approachable and visible at the service. People and relatives also told us they knew who the registered manager was and felt able to raise any concerns.

People’s health needs were met by local healthcare professionals. During our inspection we observed one healthcare professional visiting who told us they had no concerns about the care delivered.

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 11 August 2018).

Why we inspected

We received concerns in relation to incidents of safeguarding taking place but not being managed or reported to the local authority, records not being completed and people living with dementia not having the right support when they were distressed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dauntsey House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management, risk management, incidents and accident reporting and quality monitoring at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.