CQC report explained · a residential care home
What the CQC found at Dorrington House (Watton)
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staff numbers had increased, but some staff were working without the required training and support. Inspectors also found gaps in records about drinking and repositioning, and concerns about cleaning in some bathrooms.
- Effective?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Requires improvement
- Checks and oversight did not identify problems with staff training, supervision, records and cleaning. A new manager had been appointed, but there was no registered manager in post during the inspection.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found important safety and management weaknesses, although the home had improved and was no longer in special measures.
This was a focused inspection. Inspectors visited on three dates, spoke with people, relatives, staff and healthcare professionals, observed care, and checked care plans, medicines records and other safety records.
The home had improved since its previous inadequate rating. Staffing numbers had increased, medicines management was better, safety equipment had been added and communication with relatives had improved.
Important problems remained. Some new staff were working without the training and support needed for safe care. Records and checks did not reliably identify concerns about drinking, repositioning, cleaning and staff training. The home breached regulations about staffing and good governance.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. This focused inspection did not review Effective, Caring or Responsive, so their previous ratings were used in the overall rating. The home was no longer in special measures.
More staff available
Staff numbers had increased and people said their needs were met more quickly. Recruitment checks, including references and DBS checks, were in place for new staff.
“Staffing levels had increased and rotas confirmed this.” from the report
Improved medicines systems
Medicines records, stock checks and the medicines room had improved. Staff understood time-sensitive medicines and medicines used to manage diabetes.
“Medication administration record (MAR) charts were accurate, the medication room was clean and well organised and accurate stock control measures were in place.” from the report
Open communication
Relatives said communication had improved. The provider was open about the previous inspection and responded promptly to inspectors' concerns.
“The provider was open and receptive to our feedback and immediately tried to address the concerns we raised.” from the report
Staff lacked important training
seriousSome new staff worked unsupervised without training in areas such as choking risks and moving and handling. Some existing staff also lacked required or up-to-date training and supervision.
“This placed people at potential risk of avoidable harm.” from the report
Care records did not reliably show risks were managed
seriousInspectors found gaps in fluid records and repositioning charts. They could not be certain that some people's drinking and pressure care needs were being fully met.
“We could not be sure this person's repositioning needs were being fully met.” from the report
- 01What training and supervision have all staff now completed, including training on moving and handling, choking, epilepsy, seizures and first aid?
- 02How do you check that people's fluid intake and repositioning are recorded accurately and acted on promptly?
- 03Is the new electronic recording system now in use, and how do you check that the information in it is complete and accurate?
- 04Who is the registered manager now, and how are the provider's quality checks identifying and fixing problems?
- 05What action has been taken to keep bathrooms uncluttered and ensure deep cleaning is completed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 20 October 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.
What inspectors found, June 2022
Rated Inadequate and placed in special measures; inspectors found serious risks involving staffing, medicines, infection control and management.
Inspectors made two unannounced visits on 21 and 26 April 2022, including a night visit. They spoke with staff and relatives, and checked care records, medicines records, staff files and management records.
They found people were at risk of avoidable harm. The home was not clean or well maintained. Some equipment and alarms did not work. Medicines were poorly managed, including one out-of-date medicine being given. Staffing levels were not always enough, and staff did not always know people's dietary and care needs.
The home was also not well managed. Audits and checks had failed to identify or fix important problems. The overall rating fell from Requires Improvement to Inadequate. The home was placed in special measures.
Some positive family feedback
Some relatives said the people they cared about seemed settled, content and at ease. This was positive feedback, although it did not remove the safety concerns found by inspectors.
“Within two months of being there [Name] told us how settled they were and that they were not coming home.” from the report
Relatives could visit
Relatives said they visited regularly and could see people inside or in the garden. Inspectors still identified safety concerns affecting visitors.
“Feedback from people's relatives was mainly positive about visiting.” from the report
Unsafe medicines
seriousMedicine storage, cleaning and checks were poor. One person was given an out-of-date medicine, and the provider's audits had not found the problem.
“We found a person's medicine was out of date, but staff had continued to give the person the expired medicine.” from the report
Not enough staff
seriousStaffing levels were not always sufficient during the day or at night. Staff were sometimes difficult to find, and people did not always receive timely support.
“Sufficient levels of staff were not in place to keep people safe during the day and overnight.” from the report
Poor cleanliness and infection control
seriousThe home and equipment were visibly dirty, with damaged surfaces and limescale. Inspectors were not assured that infection risks, including COVID-19 risks, were being managed properly.
“Cleanliness throughout the service was poor. Equipment and communal facilities were visibly dirty.” from the report
Faulty safety equipment
seriousEquipment used to reduce falls and help people call for assistance was not working. There was no reliable checking system to identify and correct this quickly.
“Assistive technology was in use, but not working, placing people at risk of harm.” from the report
Staff did not always know people's needs
needs fixingStaff were unsure about specialist diets and food textures needed to reduce choking risks. They also did not always follow guidance about changing people's position to protect their skin.
“Staff were unfamiliar with people's care and support needs.” from the report
Weak management checks
seriousAudits and daily checks did not reflect the home's actual condition or identify important risks. Records were poor, and lessons were not consistently learned from incidents.
“The provider had poor governance and oversight arrangements in place to maintain standards and drive improvement at the service.” from the report
- 01How many staff are now on each shift, including at night, and how is this matched to people's assessed needs?
- 02How do you check that medicines are in date, stored safely, given on time and recorded correctly?
- 03Which alarms and other assistive technology were found not to work, and have all replacement items now been fitted and tested?
- 04What changes have been made to cleaning, damaged surfaces, equipment hygiene and infection control since the inspection?
- 05How are you checking that staff understand each person's diet, choking risks, repositioning needs and updated care guidance?
This was a focused inspection of Safe and Well-led only; the other key question ratings were not inspected and the overall rating used the previous inspection ratings for those questions. This explanation was written from the published report of 9 June 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 Dorrington House (Watton)
7 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- October 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- July 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 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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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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