CQC report explained · a residential care home
What the CQC found at Devonshire House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Medicines, staffing, risk assessments and most infection control arrangements were managed safely, although professional visitors were not initially screened.
- Effective?
- Good
- This key question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found approachable management, regular audits and action plans that were followed up. Staff, people and relatives were able to give feedback.
What inspectors found, February 2021
Devonshire House is rated Good; inspectors found safe, caring support and improved medicines management, with one visitor-screening issue fixed during the inspection.
This was a focused inspection on 12 January 2021. One inspector reviewed infection control, Safe and Well-led, spoke with people, relatives and staff, and checked care, medicines and management records.
Inspectors found that people felt safe and well cared for. Care plans and risk assessments were detailed, staffing levels were suitable, medicines were managed safely, and infection control procedures were mostly followed. Professional visitors were not being screened at first, but the home introduced screening during and after the inspection.
The home was rated Good overall, with Safe and Well-led also rated Good. This was an improvement from Requires Improvement at the previous inspection in 2019, when two recommendations about medicines had been made. The other three key questions were not examined during this visit.
Medicines improved
The home had acted on both recommendations from the previous inspection. Records and guidance supported safe administration and regular review of medicines.
“At this inspection the provider had implemented all of the recommended actions, made suitable improvements, and the management of medicines was safe.” from the report
Personalised risk planning
Care plans and risk assessments covered areas such as mobility, nutrition, hydration and skin care. They were reviewed monthly or sooner when needed.
“People's care plans were comprehensive and contained individual risk assessments to keep people safe.” from the report
Enough trained staff
Inspectors found enough staff on duty and suitable training in place. Staffing levels were reviewed and changed when people's needs required it.
“There were enough staff on duty to support people's needs.” from the report
Strong oversight
Management systems, audits and action plans were used to identify improvements and check that they had been completed.
“Audits were reviewed to ensure that actions were implemented, and improvements made.” from the report
Professional visitor screening
needs fixingAt the time of the inspection, professional visitors were not being screened for infection risks. The home responded immediately and put screening measures in place.
“The provider, however, was not screening professional visitors.” from the report
- 01How do you now screen professional visitors, and how do you check that this continues to happen?
- 02How often are medicines records and guidance reviewed for each person?
- 03How are staffing levels changed when people's needs increase?
- 04How are changes to a person's care plan or risk assessment shared with their relative?
- 05What were the previous ratings for Effective, Caring and Responsive, and when will these areas next be fully reviewed?
This was a focused inspection of infection prevention and control, Safe and Well-led; the other three key questions were not looked at and their previous ratings carried over. This explanation was written from the published report of 2 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.
What inspectors found, September 2019
Rated Requires Improvement and no longer in special measures; inspectors found kind, personalised care but weaknesses in medicines records and service oversight.
This was an unannounced planned inspection on 30 July and 6 August 2019. Inspectors spoke with people living at the home, relatives and staff. They observed medicines being given and checked care, medicines, staff and management records.
People told inspectors they felt safe and were happy with the care. Staff were kind and respectful. Care plans were detailed and personalised, people were supported to make choices, and food and activities generally met people's needs.
Some medicines records were incomplete or did not match the stock available. Staff knowledge about reporting safeguarding concerns outside the home was also uneven. The quality monitoring system was new and needed to be kept going. The home had improved from its previous inspection, was no longer in breach of regulations and had left special measures, but its overall rating remained Requires Improvement.
Kind and respectful care
Inspectors saw staff spending time with people and providing considerate care. People said staff were kind and patient.
“Staff were observed providing respectful, kind and considerate care.” from the report
Personalised support
Care plans described people's preferences, routines, history and support needs. Staff knew people well and encouraged everyday choices.
“People received care and support that was focused on their needs, preferences and routines.” from the report
Improved safety arrangements
Risks were assessed and updated, staffing levels were sufficient, and recruitment checks had been completed. Safeguarding incidents were investigated appropriately.
“Staffing levels were sufficient to meet the needs of the people using the service and work had taken place to ensure staff were deployed more effectively throughout the service.” from the report
Better management culture
The report found a friendly and relaxed atmosphere, with people, relatives and staff involved in the home. Management had responded to inspection feedback.
“The registered manager had used skills for care to assess the culture within the home and positive characteristics of staff members to improve the culture since the last inspection.” from the report
Incomplete medicines records
seriousSome medicine stock records did not match what was available. Guidance and recording for creams and medicines given when needed were not detailed enough, so inspectors could not confirm that these medicines were effective.
“records for some people's medicines stock did not reflect what was available. Therefore, we could not be sure these were correct.” from the report
Safeguarding knowledge
needs fixingTwo staff members were not confident about how to report safeguarding concerns outside the home. Some safeguarding refresher training was due.
“two staff we spoke to were not confident in how to raise a Safeguarding outside of the service.” from the report
Quality checks needed to continue
needs fixingThe home had introduced new audits and monitoring systems, but inspectors said these needed to be sustained. This meant there was not yet full assurance that improvements would continue.
“However, this was a new system and needed to be sustained further.” from the report
Activities not always personalised
minorActivities took place, but inspectors said activities for people living with dementia needed to be more person-centred. The activity coordinator was less confident about introducing new activities.
“In house activities still needed work to be more person centred especially for people living with dementia.” from the report
- 01How do you now check that medicines stock records match the medicines actually held?
- 02How do you record the reason for giving medicines prescribed when needed and whether they worked?
- 03Have all staff completed safeguarding refresher training, including how to report concerns outside the home?
- 04How have you kept the new quality audits going since the inspection?
- 05What activities are now available for people living with dementia, and how are they matched to each person's interests?
This was an unannounced planned inspection covering all five key questions, with the whole care home, its premises and the care provided examined. This explanation was written from the published report of 4 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.
Every inspection of Devonshire House
6 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2016Goodstayed GoodSafe: Good
- March 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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