CQC report explained · a nursing home
What the CQC found at Dorset House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, staffing, medicines and infection control were generally managed well, although some relatives had concerns about delays in answering call bells.
- Effective?
- Good
- People received support from trained staff and had suitable food, drink and access to health professionals. Staff supported people to make choices and worked within the principles of the Mental Capacity Act.
- Caring?
- Good
- People and relatives were positive about staff, and inspectors saw patient and compassionate care. Staff respected people's privacy, dignity, choices and independence.
- Responsive?
- Requires improvement
- Staff generally knew people's needs and responded to them, but some care plans were incomplete or not detailed enough. This created a risk that people might not always receive consistent, personalised care.
- Well-led?
- Good
- The manager and provider had quality checks and had acted on concerns from the previous inspection. Staff felt supported, although some relatives said actions from meetings could take a long time.
What inspectors found, August 2019
Dorset House was rated Good; inspectors found safe, kind care, but incomplete care records meant Responsive was rated Requires Improvement.
Inspectors visited on 8 and 11 July 2019. The first visit was unannounced. They spoke with people living at the home, relatives, staff and managers. They observed care and checked care, medicine, staffing and quality records.
People generally felt safe and spoke positively about the staff. Inspectors found good arrangements for medicines, staff training, food and drink, health care, dignity and activities. The home worked with health and social care professionals when people needed further support.
The main weakness was incomplete care documentation. Staff knew people well, but some care plans did not give enough detail to ensure care was always personalised and consistent. The home was asked to review and improve its care plans.
The overall rating stayed Good. Safe, Effective, Caring and Well-led were rated Good. Responsive fell from Good to Requires Improvement. Well-led improved from Requires Improvement to Good since the previous inspection.
Kind and respectful care
People and relatives spoke positively about the staff. Inspectors saw staff provide care patiently and respectfully, while supporting people's choices and dignity.
“We saw staff provided people's care and support in a patient and caring manner.” from the report
Safety arrangements
Staff understood people's risks and how to reduce them. The home checked its environment and equipment, and people said they felt safe.
“Assessments were completed to provide staff with guidance about people's risks related to their health and safety and took action to reduce these.” from the report
Food and drink
People had meal choices and could request alternatives. Staff monitored eating and drinking needs and involved health professionals when concerns arose.
“People were supported to maintain a healthy diet with their choices promoted and respected.” from the report
Activities and relationships
People could take part in activities they enjoyed, receive visitors and follow their own interests and beliefs.
“People had support from the activities coordinator and staff to participate in fun and interesting things they found enjoyable.” from the report
Improved management
The home had made improvements since the previous inspection, including stronger quality checks and medicine practices. Staff generally felt supported by the management team.
“The registered manager had addressed the areas of concern raised at the last inspection.” from the report
Incomplete care plans
needs fixingSome care plans did not contain enough information to guide staff. One person's diabetes support was not recorded in a specific care plan, and another person's fluid guidance was incomplete.
“care documentation was not always consistent in providing all the information to guide staff practices.” from the report
Risk of inconsistent care
needs fixingInspectors said people's health had not been affected, but missing details could lead to different staff responding in different ways. The home was recommended to review and amend care plans.
“there was a risk of the person receiving inconsistent care.” from the report
Time and response pressures
minorSome staff wanted more time to spend with people. Relatives also gave mixed views about how quickly call bells were answered, although inspectors did not see unreasonable delays.
“some staff said they would like more time to spend with people.” from the report
Minor infection-control shortfall
minorInspectors found that items such as toilet rolls were not always kept appropriately in some toilet and bathroom areas. The report said this could increase the risk of cross infection.
“staff did not always ensure in some toilet and bathroom areas items such as toilet rolls were not let loose on sides which could increase the risk of cross infection.” from the report
- 01What has been changed in the care plans since the inspection, especially for diabetes and fluid intake?
- 02How do you check that every member of staff has the current information needed to provide personalised care?
- 03How do you monitor call-bell response times, particularly when staff are absent or busy?
- 04What arrangements ensure nurses have enough time to give a full handover about changes in people's needs?
- 05How are infection-control checks carried out in toilets and bathrooms?
This was a planned inspection covering all five key questions, with the care provided and the home environment both examined. This explanation was written from the published report of 22 August 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, January 2017
Rated Good overall; Dorset House provided safe, kind and responsive care, but its leadership and monitoring needed improvement.
Inspectors made an unannounced comprehensive inspection on 14 and 15 December 2016. They spoke with people living at the home, relatives, staff and health professionals. They observed care and checked care records, medicines, complaints, meetings and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found improvements since the previous inspection, including safer support, suitable medicines arrangements, trained staff, respectful care and activities that reflected people's choices.
Well-led was rated Requires Improvement. The management team did not always act on concerns about staffing and did not consistently identify missing information in some care records. The overall rating was still Good, but the report shows that management systems needed to become more reliable.
Safe medicines support
Inspectors found suitable arrangements for storing, giving and disposing of medicines. Staff explained medicines and asked for consent before giving them.
“People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them.” from the report
Trained staff
Staff had regular training and said it improved their skills. Their practice was checked in areas such as safe mobility and medicines.
“We saw people were supported by staff that had received regular training and knew how to support them effectively.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff listen, offer choices and protect privacy and dignity.
“We noticed all staff engaged with people in a friendly and understanding manner.” from the report
Personalised activities
People were supported to choose how they spent their time. Activities included crafts, games, family events and individual time for people who preferred to stay in their rooms.
“The activities co-ordinator explained that along-side organised events they spent time with people who chose to stay mainly in their own rooms.” from the report
Staffing did not fully match needs
needs fixingPeople, relatives and staff raised concerns about delays and staff being too busy. The home had improved staffing, but had not fully matched staffing levels to people's increased dependency.
“However improvements had not been fully actioned to ensure staffing levels matched the dependency of people living at the home.” from the report
Management did not always act on feedback
needs fixingConcerns about staffing had been raised in meetings before the inspection, but had not been fully acted on. The management team agreed to treat these concerns as a priority.
“The management team did not consistently action feedback received about the quality of the care provided.” from the report
Incomplete decision-making records
needs fixingSome capacity assessments and best-interest decisions were not recorded clearly in the care plans. This meant staff did not always have the information they needed.
“However, we found capacity assessments and best interests meetings were not always recorded effectively to ensure all staff were aware of the outcome.” from the report
- 01How many staff are usually on duty on each shift, and how do you adjust this when people's dependency increases?
- 02What action has been taken in response to the staffing concerns raised by people, relatives and staff?
- 03How do you now check that capacity assessments and best-interest decisions are clearly recorded where staff can find them?
- 04How are complaints and feedback tracked to make sure agreed improvements are completed?
- 05What activities and one-to-one support are available for someone who prefers to stay in their room?
This was an unannounced comprehensive inspection covering all five questions; it also checked progress since the comprehensive inspection in December 2015. This explanation was written from the published report of 17 January 2017 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 Dorset House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015
Registered with the Care Quality Commission on 6 October 2015.
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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