CQC report explained · a nursing home
What the CQC found at Darwin Court Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some people experienced delays in care because of staffing levels, including waiting for help with meals. The home was recruiting permanent staff and reviewing staffing against people's needs.
- Effective?
- Good
- People's needs and risks were assessed, staff received relevant training, and people were supported with food, drinks and healthcare. Inspectors noted that food was often cold and that some dementia-related environmental improvements were planned.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were offered choices, involved in decisions and encouraged to remain independent where possible.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and life histories. People were supported with activities, relationships and end-of-life wishes, although feedback about activities was mixed.
- Well-led?
- Good
- Inspectors found improvements in leadership, auditing and learning since the previous inspection. People, relatives and staff said management was open and responsive to feedback.
What inspectors found, September 2019
Rated Good overall, but Safe Requires Improvement because some people experienced delays in care linked to staffing levels.
This was an unannounced inspection on 29 and 30 August 2019. Inspectors spoke with people, relatives and staff, observed care, and reviewed care records, medicines records, complaints, safety records and staff recruitment files.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found kind and respectful care, personalised support, suitable training, safe medicines systems and improvements in management since the previous inspection.
Safe was rated Requires Improvement. Some people waited for help, particularly at meal times and in one suite. Recruitment was continuing, but staffing levels still sometimes limited the time staff had to spend with people.
The previous overall rating was Requires Improvement, published on 29 September 2018. The home improved overall and its Well-led rating improved to Good, but Safe remained Requires Improvement.
Kind and respectful care
People were treated with dignity and respect. Staff offered reassurance, listened to people and supported their independence.
“We observed positive interactions between people and staff and saw staff members offered people reassurance when they became distressed” from the report
Safe medicines systems
Medicines were administered, stored and disposed of safely. Staff checked people's needs and offered pain relief appropriately.
“Systems used for the management of medicines were safe and staff demonstrated a good knowledge of people's health needs and how their medicines were used” from the report
Improved leadership
Management had made improvements since the previous inspection. Audits, meetings and reviews were being used to identify concerns and improve care.
“At this inspection we found improvements had been made and this key question has now improved to good.” from the report
Delays caused by staffing
seriousSome people and relatives reported delays, especially at meal times and on Friary suite. Staffing levels also sometimes left staff with little time to interact with people.
“However, some people still experienced delays in their care and further improvements were still required.” from the report
Food was often cold
needs fixingPeople generally liked the food, but almost everyone inspectors spoke to said it was often cold. Management was looking into how to improve this.
“However, almost everyone we spoke with commented on the temperature of the food and reported it was often cold.” from the report
Dementia environment still being improved
needs fixingThe building was well maintained, but some areas did not yet fully meet the needs of people living with dementia. Improvements were planned, starting with Cathedral suite.
“However, some improvements were required to ensure each individual suite was designed to meet the needs of people living there.” from the report
Mixed views about activities
minorSome people enjoyed activities, while others and some relatives felt more meaningful occupation was needed. Activities varied according to people's individual needs.
“Some people and relatives felt there were opportunities to take part in events, activities, hobbies or interests. Others felt more could be done to engage people” from the report
- 01How many permanent care staff are currently working on each suite, and how many agency staff are being used?
- 02How do you prevent delays with meals, personal care and medicines when staffing is tight?
- 03What has been done since the inspection to make sure food is served hot?
- 04What dementia-friendly environmental improvements have been completed, and what remains planned?
- 05How do you provide meaningful one-to-one activities for people who cannot join group activities?
This was an unannounced inspection covering the overall service and all five CQC questions, including the care and premises provided by the home. This explanation was written from the published report of 14 September 2019 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, September 2018
Rated Requires Improvement; inspectors found kind, effective care, but staffing levels and quality checks were not consistently good enough.
This was an unannounced inspection on 9 August 2018. Inspectors spoke with people living in the home, relatives, managers and staff. They observed care and checked care plans, medicine records, staff files, complaints, accidents and audits.
People were protected from abuse and most risks were managed properly. Medicines were given as prescribed, although some medicine records lacked signatures. Staff were trained, people had enough food and drink, and health professionals were involved when needed.
Inspectors saw kind and respectful care. People were supported to make choices, stay independent and follow their preferences. Activities, complaints handling and end of life care were rated Good, although people had mixed views about activities.
The overall rating remained Requires Improvement. The home had improved since the previous inspection, but staffing was not always sufficient and checks on care quality did not reliably identify problems.
Kind and respectful care
Inspectors observed care that was kind, patient and sensitive. Staff knew how people liked to be supported and protected their dignity and privacy.
“We observed care interactions that were kind, patient and sensitive.” from the report
Choice and independence
People were supported to make decisions about their care, daily routines, meals and activities. Staff used picture cards where needed to help people communicate.
“People were encouraged to choose for themselves, make their own decisions and maintain their independence.” from the report
Improved person-centred care
People's preferences, cultural needs and religious needs were assessed. Inspectors found the home had improved its response to people's individual needs since the previous inspection.
“At this inspection we found the service had made the required and the service was rated as Good.” from the report
Staffing delays
seriousSome people waited for care and support, including for up to 30 minutes at mealtimes on one unit. There was no specific tool to work out the staffing hours needed for people's dependency levels.
“There were not always sufficient staff to support people at the times they needed it.” from the report
Weak quality checks
seriousAudits did not reliably identify staffing shortages, incomplete checks, gaps in activity information or environmental problems. This meant managers could not be assured that people received the same quality of service across all units.
“The systems in place to check on the quality of the service people received were not consistently effective in identifying areas for improvement.” from the report
Incomplete records
needs fixingSome medicine records did not have the required signatures. Some food, fluid and care records, and checks by nurses, were also not consistently completed or signed.
“However, we saw several other records for the week which had not been signed as checked by nurses.” from the report
Mixed activity experience
needs fixingSome people said there was little to do, and some activity records did not give enough detail about individual preferences. The audit process had not identified these issues.
“One person told us, "I sit here all day, I can't see and there is nothing to do.” from the report
- 01How do you now decide how many staff are needed on each unit, especially at mealtimes and other busy periods?
- 02What checks now make sure people receive help promptly and that care, food and fluid records are completed and signed?
- 03How are medicine records checked to prevent missing signatures and confirm medicines have been given as prescribed?
- 04How do you record each person's activity preferences and check that people are happy with the activities available?
- 05What improvements have been made to the environment, including furniture, signs and decoration for people living with dementia?
This was an unannounced comprehensive inspection covering all five key questions, with the previous ratings also compared in the report. This explanation was written from the published report of 29 September 2018 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 Darwin Court Care Centre
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2016
Registered with the Care Quality Commission on 9 December 2016.
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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