Dora Rose Care Home

Dora Rose is a residential care home providing personal and nursing care to up to 71 people. The service provides support to older people, including people living with dementia, people with physical disabilities and younger adults. At the time of our inspection there were 62 people using the service.

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

During the last inspection, quality assurance processes were identified as requiring improvement. This inspection has found improvements are still required to ensure risks are effectively monitored and care documentation is kept current and in accordance to peoples changing needs.

Risks to people were not always managed or monitored safely. There were gaps in care monitoring recordings and medicines were not always effectively monitored or managed.

The provider acted quickly to the recommendations identified and took action to improve quality monitoring systems. They updated care documentation and improved processes to manage medicines safely. These will be reviewed on the next inspection.

Staff used personal protective equipment (PPE) effectively and received infection prevention control training.

There were enough staff on duty to support people's needs and staff were recruited safely.

People, relatives and staff were confident to raise concerns or complaints and told us they felt these would be listen to and acted upon.

Relatives and staff had confidence in the manager's ability to lead the service. They confirmed how the provider works in partnership to achieve positive outcomes for people.

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.

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 21 October 2021)

Why we inspected

We received concerns relating to safe monitoring and recording of people’s care. A decision was made for us to inspect and examine those risks. 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.

The provider acted during and after the inspection to mitigate the risks identified.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dora Rose 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 a breach in relation to the quality monitoring systems 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.

Dora Rose is a nursing home providing personal care to 43 people at the time of the inspection. The service can accommodate up to 71 people.

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

People could not be assured accurate records were being kept of the care provided to them. This could impact on the homes ability to monitor people’s health conditions effectively.

People could not be assured the home would always act in a timely manner when the governance systems identified issues that needed addressing.

People were cared for by staff in a way that kept them safe and protected them from avoidable harm. Enough staff were available to respond to people’s needs in a timely manner. Accidents and Incidents were investigated, and measures were taken to prevent re-occurrences. The premises were clean, and staff knew and followed infection control principles. People received their medicines safely.

People’s needs were assessed and planned and delivered in accordance with legislation and best practise. Staff were trained and knowledgeable about the needs of the people they supported. Balanced and nutritious meals were served, and people were complimentary about the quality of the food. People were supported to have 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 practise.

There were systems to ensure care was responsive. People received care in accordance with their needs and preferences. People were supported to maintain contact with their friends and families. There were opportunities for social stimulation. People felt their concerns and complaints would be listened to and responded to. People had plans relating to end of life care decisions where required.

People gave us positive feedback about the quality of care they received. The feedback on the leadership of the service and the registered manager from people and staff was positive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was registered with us on 15 November 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the service was registered.

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 coronavirus and other infection outbreaks effectively

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner