CQC report explained · a nursing home
What the CQC found at Darlington Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed and managed, staffing was sufficient, medicines were managed safely, and infection prevention and control had improved.
- Effective?
- Good
- This question was not inspected during this focused visit. Its rating was carried over from the last comprehensive inspection.
- Caring?
- Good
- This question was not inspected during this focused visit. Its rating was carried over from the last comprehensive inspection.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its rating was carried over from the last comprehensive inspection.
- Well-led?
- Requires improvement
- Management and leadership were not always consistent. Care records were sometimes incomplete, and known shortfalls in record keeping had not yet been fully addressed.
What inspectors found, January 2023
Rated Good; inspectors found safe, personalised care, but care records were not always complete and well-led was Requires Improvement.
This was an unannounced focused inspection on 27 October 2022. Two inspectors and an Expert by Experience spoke with people, relatives and staff, observed care, and checked care records, medicines records, staff rotas and quality checks.
The home was rated Good for Safe. Inspectors found suitable staffing, appropriate risk assessments, safe medicines systems, safeguarding arrangements and improved infection prevention and control. The previous breach about infection control had been resolved.
The home was rated Requires Improvement for Well-led. Care records were not always completed consistently, including records of drinks offered. The provider's checks had identified this problem, but it had not yet been fully addressed.
The overall rating was Good, up from Requires Improvement at the previous inspection. The report says the other key question ratings came from the last comprehensive inspection, because this visit only covered Safe and Well-led.
People felt safe
People told inspectors they felt safe living in the home. Staff understood how to recognise and report safeguarding concerns.
“People told us they felt safe living at Darlington Court.” from the report
Risks were managed
Care plans gave staff guidance about health, mobility, eating and drinking risks. Environmental risks were also assessed and monitored.
“Risks to people were identified, assessed and monitored effectively.” from the report
Enough suitable staff
Inspectors found enough staff to provide safe care, and people were not having to wait for support.
“There were enough suitable staff to care for people safely.” from the report
Kind and personal care
Staff knew people well and provided personalised support. Inspectors saw staff spending time with people and involving them in activities.
“People were receiving a personalised service from staff who knew them well.” from the report
Improved infection control
Improvements in infection prevention and control had been sustained. The previous breach in this area had been resolved.
“At this inspection we found management of the prevention and control of infection had improved and there was no longer a breach of regulation.” from the report
Incomplete care records
needs fixingRecords did not always show that people had been offered drinks throughout the day. This meant managers could not always be sure that everyone had received the care they needed.
“Some records relating to people's care were not consistently completed.” from the report
Known issue not fully addressed
needs fixingThe provider's quality checks had already found problems with record keeping, but action had not yet fully corrected them.
“The provider's systems for auditing had identified shortfalls in record keeping. This had not yet been addressed.” from the report
- 01What specific steps are being taken to make sure drink records are completed every day?
- 02How will managers check that the record-keeping problem has been fully fixed, and by when?
- 03How do you decide whether there are enough staff for people's changing needs?
- 04What systems are now in place to prevent medicine errors and make sure medicines are always available?
- 05How have you maintained the improvements in infection prevention and control since the previous breach?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the comprehensive inspection published on 10 March 2020. This explanation was written from the published report of 5 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2021
Rated Requires Improvement; inspectors found kind care and safe medicines, but infection control and management oversight were not always reliable.
The inspection took place on 1 December and 23 December 2020. It was prompted by concerns about a COVID-19 outbreak. Inspectors spoke with staff, managers and relatives, observed care, and checked care, medicines, cleaning and quality records.
The home had enough staff to meet people's needs, and staff used suitable protective equipment. Medicines were given safely. Staff knew people well, treated them kindly and worked with local health and care organisations.
However, some infection control procedures were not followed during the outbreak. People were admitted when the home's outbreak plan said this should not happen, cleaning records had gaps, and staff could not always stay within planned areas. The systems meant to detect and prevent these problems had not worked well enough.
Only Safe and Well-led were inspected. Both were rated Requires Improvement, and the overall rating fell from Good at the previous comprehensive inspection to Requires Improvement.
Kind staff
Inspectors saw staff supporting people with kindness. Relatives also spoke positively about the care and communication.
“We saw staff supporting people with kindness.” from the report
Medicines
The medicine records checked were accurate. Medicines were stored securely, and checks had led to corrective action when errors were found.
“The MARs we saw were completed accurately and correctly.” from the report
Staffing levels
The staffing assessment tool accurately showed how many staff were needed, and inspectors' observations supported this. Staff worked hard during the outbreak.
“Staff had worked exceptionally hard during the outbreak to keep people safe and meet their needs.” from the report
Risk support
Care plans included information about mobility, falls and health conditions. Staff had training and followed guidance for people's specific needs.
“Staff knew people well and understood risks associated with their care.” from the report
Working with other organisations
The home worked with the Local Authority, Public Health and the Clinical Commissioning Group during the outbreak and related concerns.
“The service had liaised with organisations within the local community.” from the report
Admissions during the outbreak
seriousThree people were admitted for respite care and one person was admitted permanently during the COVID-19 outbreak, contrary to the home's outbreak plan. Inspectors could not be assured that admissions were safe.
“After our first day of inspection, despite the service being in an outbreak, three people were admitted to the service for respite care, and one person was admitted permanently without agreement from senior regional staff.” from the report
Infection control procedures
seriousCleaning records had gaps, and staff could not always stay within planned areas because of sickness and agency staffing. This increased the risk of infection spreading.
“People had been placed at risk as the provider had failed to assess the risk of, and ensure the, prevention, detection and controlling of infections.” from the report
Management oversight
needs fixingThe home's policies and governance systems did not identify or stop unsafe admissions. The overall rating for leadership fell from Good to Requires Improvement.
“The provider's systems of governance should have had oversight of this and prevented these admissions, in line with their policies and procedures.” from the report
- 01What has changed since the inspection to make sure admissions are safe during any infection outbreak?
- 02How do you record and check cleaning of touch points such as handrails and door handles?
- 03How do you keep staff in planned areas when there are high sickness levels or agency staff shortages?
- 04What action plan was sent to the CQC after the Regulation 12 breach, and what progress has been made?
- 05How do you check that the home's outbreak management plan and pandemic plan are followed in practice?
This was a focused inspection following COVID-19 concerns and covered Safe and Well-led only; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Darlington Court
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not rated
- March 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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