CQC report explained · a residential care home
What the CQC found at Docking House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer risk assessments, safe equipment and appropriate medicines management. Staff understood safeguarding and infection control.
- Effective?
- Good
- Care was based on assessments and regularly reviewed. Staff had relevant training, people received support with food and drink and healthcare professionals were involved when needed.
- Caring?
- Good
- Staff were described as kind and respectful. People were offered choices, involved in care decisions and supported to keep their dignity and independence.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and communication needs. Inspectors found a range of activities, accessible ways to give feedback and support with end of life wishes.
- Well-led?
- Good
- The home had improved systems for quality checks, clearer staff responsibilities and an open management approach. Staff, people and relatives said managers were approachable and supportive.
What inspectors found, September 2019
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
Inspectors visited unannounced on 6 August 2019. They spoke with people living at the home, relatives, staff and a healthcare professional. They observed care and checked care plans, daily records, medicines records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, kind care and personalised support. People were supported with food, healthcare, activities and end of life care.
The previous inspection rated the home Requires Improvement and found a breach relating to risk assessments. The provider made changes, and inspectors found the breach had been resolved. The overall rating improved to Good.
Improved risk management
The home had improved how it assessed and recorded risks. Staff knew the actions needed to keep people safe.
“The registered manager had implemented an improved system of assessing and recording potential risks to people's safety and well-being.” from the report
Safe staffing and medicines
Inspectors found enough staff on duty and saw that medicines were received, stored, given and recorded safely.
“There was enough staff on duty to enable people to remain safe and receive care in a timely way.” from the report
Kind and respectful care
People were treated warmly and with respect. Staff supported people's dignity, choices and independence.
“We witnessed many positive interactions between staff and people they supported which were warm and friendly.” from the report
Personalised support and activities
Care plans included people's preferences and communication needs. People could join group activities or spend time with staff individually.
“There was a range of activities provided to people and these included exercises, visits from a pet therapy dog, musical entertainment, card games or quizzes.” from the report
Open management
The inspection found better governance, clearer staff responsibilities and a manager who was visible and approachable.
“The provider had an improved overarching governance system to ensure that good quality care and support was provided” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently assess and review risks for my relative, especially risks linked to mobility, health conditions or nutrition?
- 02How many staff are normally on duty, and how are they deployed to monitor communal areas and respond to requests for help?
- 03How will my relative's preferences, life history, communication needs and dementia-related triggers be recorded and kept up to date?
- 04What activities are available, including one-to-one support for someone who does not want to join group activities?
- 05How are end of life preferences discussed, recorded and shared with relatives and healthcare professionals?
This was an unannounced inspection covering all five CQC questions, including the care, accommodation, management systems and records checked during the visit. This explanation was written from the published report of 12 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, August 2018
Docking House was rated Requires Improvement; inspectors found progress, but risks, care records, staffing cover and people's daily support were not yet consistently safe or effective.
This was an unannounced inspection on 9 July 2018. Three inspectors spoke with people, relatives, staff and health professionals. They observed care and looked at care records, medicines records, audits, staff files and training records.
The home had improved since the previous inspection in November 2017. It was no longer rated Inadequate in any area. However, inspectors still found unclear and conflicting risk information, unsafe moving and handling, gaps in supervision, poor fluid monitoring, inconsistent activities and some staff responses that were not caring.
All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. This means improvements had been made, but the service was not yet consistently providing the standard of care people should receive.
Medicines
People received medicines as prescribed. Records, storage, audits and guidance for medicines given when needed were found to be well managed.
“People received their medicines as the prescriber intended, the audits of people's medicines were robust.” from the report
Staff checks and training
New staff had the required recruitment checks before working unsupervised. Training, induction and competency assessments had improved since the previous inspection.
“The number of hours staff were working had also reduced and they no longer worked an excessive amount whereby they became fatigued and less effective.” from the report
Safeguarding
Staff understood how to recognise and report abuse. The home had improved its reporting of safeguarding concerns to the local authority and CQC.
“Staff had undertaken training in the safeguarding of adults, and could tell us how to recognise indicators of abuse.” from the report
Healthcare support
People's health was monitored and staff sought advice from GPs, dietitians, community professionals and other specialists when needed.
“We spoke to a community professional who told us that staff contacted them for support in a timely way.” from the report
Involvement and complaints
People and relatives were involved in care planning where possible. Complaints were recorded, responded to and used to improve the service.
“We reviewed records that showed complaints were responded to and managed within the provider's stated timeframes.” from the report
Unclear risk information
seriousSome care records gave conflicting or inaccurate instructions about mobility, falls and skin risks. This could make it unclear how staff should keep someone safe.
“The information in the persons plan was conflicting and inaccurate.” from the report
Unsafe moving and handling
seriousInspectors saw staff lift a person from the floor without proper checks or mobility equipment after a fall. They also saw other unsafe practices that could cause injury.
“This is unsafe moving and handling practise.” from the report
Supervision and staffing cover
seriousCommunal areas were sometimes left without staff when people needed constant observation. The home planned to recruit another staff member, but this had not yet happened.
“The way in which staff were deployed meant that communal areas were left unsupervised which posed a risk to people that need constant monitoring.” from the report
Responses to distress
needs fixingStaff did not always acknowledge people who were upset or asking for comfort. Inspectors saw some good reassurance, but responses were inconsistent.
“The staff member did not approach and did not offer the comfort that the person had asked for.” from the report
Activities and personal information
needs fixingActivities had improved but were not provided consistently because staffing resources had not yet been put in place. Some care records did not explain how to support people's interests or routines.
“The provision of activities was improving but required further staffing resources to ensure this could be delivered regularly.” from the report
- 01What has been done to make mobility, falls and skin-risk care plans accurate and consistent?
- 02How do you ensure communal areas are supervised whenever people need constant monitoring?
- 03What changes have been made to moving and handling practice, and how are staff's competencies checked now?
- 04How do you record food and fluid intake, and what happens when someone misses their daily target?
- 05How often are activities now provided, and how are they matched to each person's interests and abilities?
This was an unannounced comprehensive inspection covering all five CQC questions and the care and accommodation provided. This explanation was written from the published report of 30 August 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 Docking House
5 rated inspections over 5 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 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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13 live-in carers within about an hour of Norfolk
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Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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