We carried out a review of the data available to us about Deangate 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 Deangate Care Home, you can give feedback on this service.
We found the following examples of good practice.
Government guidance was being followed and the home had supported visits to recommence safely within the home. Effective systems were in place to ensure visitors to the service followed government guidelines for wearing Personal Protective Equipment (PPE). Facilities were available for visitors to sanitise their hands and put on PPE. A temperature check and lateral flow screening test were standard requirements for all visitors.
All staff were trained in safe infection, prevention and control (IPC) practices. The service carried out regular IPC audits and had an IPC policy.
Appropriate checks were undertaken before people moved into the home to reduce the risk of infection being introduced to the home. This included obtaining evidence the person had recently tested negative for COVID-19.
The premises were clean. There was a cleaning schedule in place and suitable cleaning products were used to control the spread of infection. Staff regularly cleaned frequent touch points, such as handrails and light switches.
A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. There had been a good uptake of people receiving the COVID-19 vaccine.
Deangate Care Home is a residential care home providing personal care to 44 people. The service can support up to 46 people over two floors. One of the units specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
People and their relatives were positive about the service and the care provided. People told us they thought the food was good.
People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Sufficient staff were available to meet people’s needs and we saw staff responding promptly to requests for assistance. Support was given in an unhurried manner. People received their medicines as prescribed and systems were in place to ensure these were administered according to best practice guidelines. Incidents and accidents were investigated and actions were taken to prevent recurrence. Premises were clean and staff followed infection control and prevention procedures.
People’s needs were assessed and care was planned and delivered to meet legislation and best practice guidance. Care was delivered by staff who were trained and knowledgeable about people’s care needs. People were provided with a varied menu and staff encouraged and supported them to eat and drink. 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 kind, caring and compassionate. The home was welcoming and friendly and it was clear people and staff had formed good relationships. People and relatives were involved in decision making. Staff respected people’s privacy and dignity.
Staff were responsive to people’s needs and wishes and knew people well. People were offered choices about what they wanted to eat and what activities they wished to take part in. People’s views were sought and action taken to improve the service from these.
The registered manager was proactive and people and staff knew them well.
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 30 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The inspection took place on 4 January 2017 and was unannounced which meant we did not notify anyone at the service that we would be attending.
Our last inspection at Deangate took place on 23 June 2015. Following the inspection the service was rated as Requires Improvement. At that inspection we found there was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because staff were not always deployed in a way to meet the needs of people at the service.
We found evidence on this inspection to show improvements had been made to meet the requirements of Regulation 18, Staffing, as improvements to the way staff were deployed had been made.
There was a registered manager who had been in post since December 2015 and was registered with CQC in July 2016. 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.
People spoken with told us they felt safe living at Deangate and they liked the staff.
We found systems were in place to make sure people received their medicines safely.
There were sufficient staff to meet people’s needs safely and effectively and staff recruitment processes were safe and robust.
Staff underwent an induction and shadowing prior to commencing work, and had regular updates to their training to ensure they had the skills and knowledge to carry out their roles. Staff received supervisions and appraisals regularly and were well supported by the registered manager.
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 had access to a range of health care professionals to help maintain their health. A varied diet was provided to people which took into account dietary needs and preferences so their health was promoted and choices could be respected.
Some activities were provided and a range of local community groups and entertainers visited the home to provide leisure opportunities.
People living at the home, and their relatives said they could speak with staff if they had any worries or concerns and they would be listened to.
There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via questionnaires. The results of these had been audited to identify any areas for improvement. The results of the questionnaires were displayed in the foyer of the home.
The inspection took place on 10 and 23 June 2015 and was unannounced which meant we did not notify anyone at the service that we would be attending.
The service was last inspected on 11 and 17 November 2014 and was found not to be meeting the requirements of ten of the regulations we inspected at that time. These related to quality assurance, medicines management, consent, care and welfare, safeguarding of people, staffing, supporting staff, respecting people, infection control and nutrition. The provider sent a report of the actions they would take to meet the legal requirements of these regulations. The provider informed us they would be compliant by the end of April 2015.
Deangate care home accommodates up to 50 older people that require nursing and personal care. Included within the home is a unit called Poppy Lane which can accommodate up to 12 people who may be living with dementia. At the time of our inspection there were 34 people using the service; nine people in Poppy Lane unit and 25 people in the rest of the home, referred to as Deangate.
Although there was a manager at the home, they were not yet registered with the commission and they told us they were in the process of submitting an application. 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.
Staff had concerns about the staffing levels in place which they felt left them unable to meet people’s needs and preferences. Some staff told us about occasions when staff had not been in place to ensure all areas of the service were covered, such as cleaning and laundry. At the inspection the operations manager told us the manager would take over the role of scheduling staff on duty. They also said a new system had been implemented whereby staff could call to request assistance from other parts of the home during busy periods.
We were told differing information about the staff handover procedure between shifts at the home. The majority of care staff we spoke with saying they were not always made aware of changes to people’s needs. The operations manager and manager told us they would review this to ensure it worked effectively.
Some observations and noticeable malodours showed that infection control processes were still not fully robust. We saw action was being taken to identify and address these areas and the home was still working towards completion of an action plan following visit from an infection control team in March 2015 which had also highlighted areas of good practice.
We saw evidence of regular updates to people’s care plans and individual risk assessments. Staff knew how to report abuse and we saw evidence of safeguarding referrals made appropriately so that systems were in place to reduce further risk. Care was provided in people’s best interests and in accordance with the principles of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards were in place where these had been identified as being required and further applications were in progress.
We observed safe practices during medication administration. Medication records contained clear information about people’s needs and the records we checked showed that medicines had been administered appropriately.
Although we were told about some activities taking place, there was a lack of stimulation at times for people using the service. Few activities were observed however we did see some positive interactions between staff and people to provide stimulation. Staff told us they did not have time to do this as much as they’d like to. People we spoke with commented positively about the staff and how they were cared for. We saw instances of caring interactions between staff and people. We observed staff offer reassurance to people when they were providing support and promoted independence.
We saw evidence of regular residents and relatives meetings and feedback surveys had been provided to people and their relatives. We saw that the results of these had been analysed and actioned with areas for improvement.
Regular team meetings took place with staff. Staff comments varied about how well they felt supported by management. Comments from other professionals, the local authority and feedback from people and relatives were positive about changes in the home and the new management. We saw that audits and quality monitoring of the service were completed routinely and actions were followed up appropriately. Analysis of incidents took place with an aim to reduce further recurrences. The manager made notifications to the commission where required.
We found that although the service had made improvements, further work was still required to meet the requirements of the regulation to ensure suitable staff resources were deployed at the service for it to operate effectively.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
The inspection took place on 11 and 18 November 2014 and was unannounced which meant the provider did not know we were attending. On the 18 November 2014 we attended at 04:00 hours to observe how the service operated during a night shift.
The service was last inspected on 14 October 2013 and was found to be meeting the requirements of the regulations we inspected at that time.
Deangate care home accommodates up to 50 older people that require nursing and personal care. Included within this is a unit called Poppy Lodge which can accommodate up to 12 people who are living with dementia. At the time of our inspection there were 43 people using the service; 12 people in the Poppy Lodge unit and 31 people in the main part of the home, referred to as Deangate.
There was a registered manager in place at the time of the inspection. 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.
People were not safe and were not protected from risk of harm. Staffing arrangements were insufficient and care was not being delivered in a way to meet people’s needs. The second part of our inspection took place during a night shift and we found a number of concerns. On our arrival we saw four staff were on duty but none of the staff were located on Poppy Lodge. We found that some people on Poppy Lodge were locked in their rooms by staff who told us this was done to keep the person safe. Staff told us that none of them were based on the unit and they made regular checks on people during the night. We observed one person on Poppy Lodge getting in and out of other people’s beds. Staff comments and records showed this was a regular occurrence with some people on Poppy Lodge. People were mainly unsupervised despite their care plans stating they needed supervision for their own safety as well as the safety of others.
Some people displayed behaviours that challenged the service which resulted in physical incidents occurring. Our review of records showed that some incidents had not been referred to the local authority safeguarding team which meant the service was not meeting requirements to ensure people were protected people against the risk of abuse.
People were not protected from the risks associated with unsafe medicines management.
We observed unsafe practices during medication administration. Where people had medicines prescribed ‘as required’ there were not always clear guidelines in medication records as to what criteria was to be used to determine when these should be given .
Staff were not appropriately supported to ensure they fulfilled the responsibilities of their roles. The induction process was not of a sufficient level to ensure people were equipped with appropriate knowledge to competently perform their duties.
The Mental Capacity Act (MCA) 2005 is an act which applies to people who are unable to make all or some decisions for themselves. We saw examples of where staff did not act in accordance with this and had consented to decisions for people without following the procedures set out in the act.
People’s nutritional needs were not always met as individual preferences were not always taken into account. We saw instances where people needed support to eat their meals and their daily records did not always show what people had consumed. We noted some people in the home had experienced weight loss. Referrals had been made to other health professionals where this had been identified.
There was a lack of stimulation for people using the service. Very few activities were observed with none being seen to take place on Poppy Lodge. People were observed to sit for long periods with little or no interaction. Care duties were performed in a routine like manner that benefitted the staff as opposed to meeting the individual needs of the person.
Although we saw instances of caring interactions between staff and people using the service, we saw occasions where people were not respected and did not have their dignity maintained. We observed that staff at times did not speak to people or offer reassurance when they were providing support. A care worker audibly disclosed personal information about a person at the home in front of them and other people.
Observations around the home showed that infection control processes were not robust enough to minimise and prevent the risk of spread of infection.
Audits and quality monitoring of the service were not effective and issues identified were not acted upon accordingly. Analysis of incidents was not of a level to identify trends and investigate ways to try to reduce these.
We found ten breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.
People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People told us, 'We have two choices of sandwiches for tea in the week and three on Sunday' and 'If you get fed up of it here [the lounge] then you can just take yourself off to your room.'
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People's comments included, 'You can't beat it here, good food and good help when you need it", 'It's home to me' and 'It can never be like your own home, but it's ok.'
People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People we spoke with said they felt safe living at the home.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.
The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.
The manager at the time of our inspection was not the registered manager named on this report. We advised the current manager she is required to apply for registered manager status and the previous manager must apply to de-register.
People experienced care, treatment and support that met their needs and protected their rights. People told us that they were happy with the care they received. One person said "I wouldn't change anything, its lovely here."
People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider carried out regular audits of the premises to ensure that they remained in good condition and fit for purpose.
People were cared for, or supported by, suitably qualified, skilled and experienced staff. Staff were provided with a range of training opportunities to ensure that their skills and knowledge remained up to date and that they understood the needs of people they were supporting.
There was an effective complaints system available.Comments and complaints people made were responded to appropriately. We spoke with five staff who were knowledgeable with the procedure for receiving complaints from people using the service. Staff also knew the process for making a complaint.