CQC report explained · a residential care home
What the CQC found at Dearnlea Park Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Dearnlea Park Residential Care Home was rated Requires Improvement; inspectors found risks with medicines, care records and management oversight.
This was an unannounced focused inspection on 20 June 2023. Inspectors spoke with people living in the home, relatives and staff. They observed daily life, checked the building, and reviewed care records, medicine records, staff files and management records.
Inspectors found continued problems with medicines. Staff competency checks and training were not always up to date. Guidance for giving medicines was sometimes missing, and medicines were not always stored at safe temperatures. Risks to people were not fully assessed or clearly explained in care plans.
Staff were kind, knew people well and there were enough staff to meet people's needs. However, training, care records, consent records and quality checks were not always complete. The overall rating remained Requires Improvement, with the Safe, Effective and Well-led areas also rated Requires Improvement.
Kind staff
Inspectors saw staff being kind and caring. Staff appeared to know people well and were committed to providing good care.
“We saw staff were kind and caring in their interactions with people.” from the report
Staff availability
Inspectors found enough staff to meet people's care and support needs in a timely way. People said staff responded quickly when they needed help.
“There were enough staff deployed to meet people's needs in a timely way.” from the report
Safe recruitment
Recruitment records included identity checks, references and Disclosure and Barring Service information to help check staff suitability.
“The process of recruiting staff was safe.” from the report
Food and healthcare
Most people spoken to liked the food, and staff understood different dietary needs. People were supported to access health and social care services.
“Staff encouraged and supported people to eat and drink as required.” from the report
Medicines
seriousThe home could not assure inspectors that staff were competent to manage medicines safely. Guidance was sometimes missing, training and checks were not always current, and storage problems were found.
“Medicines were not managed safely. We were not assured of staff competency in this area.” from the report
Risk assessments
seriousSome risks were not fully assessed, and care plans did not always explain how staff should reduce or manage them. This placed people at risk of harm.
“Risks to people were not fully assessed.” from the report
Management oversight
seriousThe provider had not put effective quality assurance systems in place. Audits did not identify all the problems found, and there was no overall action plan to track improvements.
“The provider had failed to keep oversight of the service.” from the report
Staff training and support
needs fixingMany staff were behind with training, not all agency staff had induction records, and not all staff received supervision as required. No staff appraisals had been recorded in the previous 12 months.
“Training records showed a large number of staff were behind on completing their training within expected timescales.” from the report
Care and consent records
needs fixingCare records did not always accurately describe people's needs, choices and history. Records of consent or best-interest decisions were sometimes missing for significant decisions.
“People's care records did not always contain up to date information about their needs or choices.” from the report
Environment and dining
minorThe building was tired, some furniture and fittings needed replacing, and the upstairs dining experience was described as brusque and institutional.
“The premises were tired and in need of a refresh.” from the report
- 01What checks now confirm that every member of staff who gives medicines is competent, and how often are these checks completed?
- 02How are medicine instructions, including guidance for as-required medicines and creams, kept up to date and checked?
- 03How are individual risks recorded and reviewed, particularly risks linked to behaviour and fire evacuation?
- 04What action plan is being used to fix the care record, training and quality assurance problems identified by inspectors?
- 05How will the home record people's consent and best-interest decisions when restrictive measures, such as bed rails, are considered?
This was an unannounced focused inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected, and the overall rating used the relevant previous ratings. This explanation was written from the published report of 3 August 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, December 2021
Dearnlea Park Residential Care Home was rated Requires Improvement; inspectors found risks with medicines, care records, health and safety checks, and quality monitoring.
This was an unannounced focused inspection on 9 November 2021. Two inspectors spoke with people, a relative, staff and visiting health professionals. They also reviewed training information and quality records.
The home was rated Requires Improvement overall, and for Safe and Well-led. Inspectors found that medicines checks, risk information, fire safety arrangements and quality monitoring were not reliable enough. They said this placed people at risk, although they found no evidence that anyone had been harmed.
Inspectors also found enough staff, safe recruitment, effective safeguarding systems and positive feedback about the care. The provider took some immediate action and sent a service improvement plan. CQC said it would monitor progress and return to inspect.
Enough staff
Inspectors found enough staff available to meet people's needs in a timely way.
“We found there were enough staff available to meet people's needs in a timely way.” from the report
Safeguarding
Staff understood how to keep people safe and how to report suspected abuse.
“Staff were able to confirm they knew how to report any incidents of abuse.” from the report
Safe recruitment
Recruitment checks were completed before staff started work.
“Pre-employment checks had been carried out prior to staff commencing in post.” from the report
Health partnerships
Inspectors received positive feedback from visiting health professionals, and staff made referrals to relevant services.
“Staff routinely made referrals to other services and were familiar with health professionals and their scope of support.” from the report
Medicines management
seriousNot all staff had their medicines competency checks reviewed often enough. Guidance for medicines given when needed was missing, and medicines audits were not always regular.
“Protocols to safely manage the administration of as and when required medicines (PRN) were not in place.” from the report
Risk and fire safety
seriousHealth and safety checks had not been completed properly. There was no review of the fire risk assessment and no effective system to ensure staff knew how to support people during a fire.
“Health and safety checks had not been carried out which put people at risk of harm should there be an emergency.” from the report
Incomplete care information
seriousCare records and risk assessments did not always give staff enough information. Some information had not transferred from paper records to the electronic system.
“Records of care and support were not accurate or up to date and staff did not always have access to clear information about the people they were supporting.” from the report
Weak quality checks
seriousThe home did not have formal audits to check quality and manage risks. Inspectors also found that some policies were not being followed.
“Quality assurance systems were not in place to check the quality of the service and manage risks.” from the report
- 01What has been done to make sure every staff member's medicines competency is checked at the required frequency?
- 02Are there now clear protocols for medicines given as and when needed, and how often are medicines audits completed?
- 03Has the fire risk assessment been reviewed, and how do you check that staff know what to do in a fire?
- 04How were paper care records transferred to the electronic system, and how do you check that no important information is missing?
- 05What formal quality audits are now completed, and how is progress on the service improvement plan checked?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 December 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 Dearnlea Park Residential Care Home
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Dearnlea Park Residential Care Home →
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Dearnlea Park Residential Care Home →
- November 2018GoodSafe: GoodEffective: GoodWell-led: Good
- August 2017
Registered with the Care Quality Commission on 29 August 2017.
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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