CQC report explained · a residential care home
What the CQC found at Dolphinlee House Home for Older People
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were administered safely, risks were assessed and there were enough staff to support people. Recruitment checks, safeguarding arrangements and infection control systems were also found to be in place.
- Effective?
- Good
- Staff had completed relevant training and people’s health, nutrition and hydration needs were supported. The main shortfall was that capacity assessment documentation was not always completed correctly.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its rating was carried over from the previous inspection.
- Responsive?
- Requires improvement
- This key question was not inspected during this focused inspection. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- The provider and registered manager had improved audits, communication and oversight of safety and quality. Staff said they had noticed improvements and felt able to make suggestions.
What inspectors found, August 2023
Dolphinlee House Home for Older People is rated Good; inspectors found safer medicines management, suitable staffing and better oversight, with some capacity records still needing improvement.
This was an unannounced focused inspection on 11 and 14 July 2023. Inspectors reviewed care and medicines records, staffing and recruitment information, service records and policies. They also spoke with people living at the home, a relative and staff.
The home was rated Good overall. Inspectors found improvements since the previous inspection in medicines, risk assessments, staff training and checks on the safety and quality of care. People said they felt safe and spoke positively about the staff.
Inspectors found one remaining shortfall. Records used to assess whether people could make certain decisions were not always completed correctly. They recommended that these records should be completed accurately and consistently.
Safer medicines
Medicines were given as prescribed, with improved records for refused medicines and guidance for medicines given when needed.
“People received their medicines safely and as they had been prescribed.” from the report
Risk management
Risks relating to people’s needs were identified and plans told staff how to manage them. Accidents and incidents were reviewed for lessons and trends.
“Risks relating to people's needs had been identified, assessed and appropriate plans were in place informing staff on how to manage those risks.” from the report
Staffing and training
Inspectors found enough staff and suitable recruitment checks. Staff had completed relevant training and people said staff were well trained.
“Staff told us and records seen showed they completed a range of training to give them the skills and knowledge to provide people's support.” from the report
Improved oversight
The provider had improved audits, communication and recording systems since the last inspection. Staff reported clear improvements in the service.
“There have definitely been improvements especially in communications, recording systems and we've had more training.” from the report
Capacity records
needs fixingRecords used to establish whether people could make particular decisions were not always completed accurately. The inspectors made a recommendation for this to be corrected and completed consistently.
“The provider's documentation used by staff to assess people's capacity and their ability to make certain decisions was not always completed correctly.” from the report
- 01How do you now check that capacity assessments and related decision records are completed accurately and consistently?
- 02How do you monitor medicines that are refused, including laxatives and other medicines given when needed?
- 03How do you make sure staffing levels remain sufficient when agency staff are used?
- 04What audits do you carry out to check that improvements in recording, communication and training are being maintained?
- 05How will you involve my relative and our family in care planning and decisions about their care?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their ratings were carried over from the previous inspection. This explanation was written from the published report of 18 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, September 2022
Dolphinlee House Home for Older People is rated Requires Improvement, with Safe rated Inadequate because medicines and risk controls were unsafe.
This was an unannounced focused inspection on 15 and 21 July 2022. One inspector spoke with eight people and eight staff, checked care, medicines, staffing and management records, and observed the home.
Inspectors found enough staff on duty and safe recruitment. People said they felt safe, and staff knew how to report abuse. However, risk assessments were incomplete, medicines were not managed safely, some staff had not completed required training, and infection control practices were not always followed.
The home was not consistently working within mental capacity rules. Some restrictive care had no appropriate legal authorisation. Fire safety improvements had also not been dealt with promptly, although the provider said during and after the inspection that the actions had been completed.
The overall rating remains Requires Improvement. Safe fell from Requires Improvement to Inadequate. Well-led remained Requires Improvement. The other three areas were not inspected, so their previous ratings were carried forward.
Enough staff
Inspectors found adequate staffing and saw staff respond promptly to requests for help.
“Rotas and our observations showed that there were adequate numbers for staff to support people in a timely manner.” from the report
Safe recruitment
The home followed robust recruitment procedures to help prevent unsuitable staff being employed.
“People were protected against the employment of unsuitable staff because robust recruitment procedures were followed.” from the report
Safeguarding response
Staff knew how to recognise and report abuse. The manager had followed safeguarding procedures and shared relevant information.
“Staff knew how to recognise potential abuse and report any concerns.” from the report
Working with other services
The home worked with health and social care professionals to support people's health and rehabilitation needs.
“The manager had developed close links and working relationships with a variety of professionals within the local area.” from the report
Unsafe medicines management
seriousMedicines were not always given or recorded safely. Allergy information was missing from eight records, and repeated refusals were not always reported to health professionals.
“Staff did not share concerns regarding people who constantly refused their prescribed medicines to health professionals.” from the report
Incomplete risk assessments
seriousRisks linked to equipment, medical conditions and people's care needs were not always assessed or recorded. This included risks from bed levers and diabetes.
“The provider had not assessed risks associated with the use of equipment such as bed levers.” from the report
Required training not completed
seriousSome staff had not completed training the provider considered necessary for their roles and for people's specific needs.
“The provider had failed to adequately ensure that staff were suitably qualified for their role.” from the report
Weak quality checks
needs fixingCare plan, medicines and environmental audits did not identify problems before the inspection. The provider had also not fully addressed issues from the previous inspection.
“Care plan audits, environmental audits and medicines audits were not effectively implemented.” from the report
Infection control gaps
needs fixingOn the first inspection day, some staff were not wearing masks as recommended and visitors were not checked for COVID-19 symptoms on arrival.
“We were somewhat assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Missing legal authorisations
seriousSome people receiving restrictive care did not have the appropriate Deprivation of Liberty Safeguards authorisation or application.
“We found appropriate legal authorisations had not been sought for people whose care included restrictive practices to ensure their safety.” from the report
- 01What has been done to make medicines safe, including PRN guidance, allergy records and support for people who refuse medicines?
- 02How are risks from bed levers, medical conditions and short-term or intermediate care now assessed and recorded?
- 03Which staff training was incomplete at the inspection, and how do you check that all required training is now completed?
- 04What action has been taken in response to the Regulation 12 and Regulation 17 warning notices?
- 05How do you ensure restrictive care has the correct Mental Capacity Act and Deprivation of Liberty Safeguards authorisation?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 21 September 2022 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 Dolphinlee House Home for Older People
6 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Dolphinlee House Home for Older People →
- September 2022Requires improvementstayed Requires improvementSafe: InadequateWell-led: Requires improvement
Read what inspectors found at Dolphinlee House Home for Older People →
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: Requires improvement
- April 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 2 February 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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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.