CQC report explained · a residential care home
What the CQC found at Dover Cottage Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Staff generally kept people safe, but staffing plans and deployment needed review because of a recent increase in distress and challenging behaviour. Inspectors also identified minor medicines-record issues and some safety checks and repairs needing attention.
- Effective?
- Good
- The home worked with health professionals, supported eating and drinking, and provided staff training and supervision. It also used capacity assessments and followed up applications relating to restrictions on people's liberty.
- Caring?
- Good
- Inspectors saw kind, calm and respectful interactions. Staff knew people well, supported their choices and involved people and relatives in understanding their care and life history.
- Responsive?
- Good
- Care plans recorded people's preferences, communication needs and changing support needs. Staff mainly provided individual activities, while going out and access to the garden were areas still being developed.
- Well-led?
- Good
- Management and quality checks had improved, and a registered manager was in post. Staff felt supported, and the home responded to feedback from people, relatives, the local authority and other professionals.
What inspectors found, August 2019
Rated Good overall, but inspectors found staffing arrangements and some safety checks needed improvement.
This was an unannounced inspection on 24 July 2019. Inspectors spoke with people, a relative and staff, observed care, and checked care, medicines, recruitment, training and management records.
People generally received kind, personalised care. Staff knew people well, supported people living with dementia and worked with health professionals. Food, drink and personal choices were well supported.
The Safe rating was Requires Improvement. Inspectors found that staffing needed to be planned more flexibly as some people had recently become more distressed, and they identified minor issues with medicines records, safety checks and repairs.
The overall rating remained Good. Effective, Caring, Responsive and Well-led were all rated Good. Compared with the previous inspection, Well-led improved from Requires Improvement to Good, while Safe fell from Good to Requires Improvement.
Kind and personalised care
Staff spent time with people individually and responded calmly when people became distressed. Inspectors saw respectful care and relatives praised the support given.
“We observed kind, caring and calm interactions between people who lived at the service and staff.” from the report
Good understanding of people
Staff knew people's likes, dislikes, communication needs and life histories. Care plans and 'This Is Me' documents helped staff provide individual support.
“Many staff had worked at the service for a long time and it was clear they knew people very well.” from the report
Food and health support
People had plenty of food and choice, with staff adapting meals and portions to individual needs. The home worked with health professionals where people had difficulty eating or swallowing.
“Kitchen staff ensured they gave people lots of choice and prepared their favourite meals as often as possible.” from the report
Improved leadership
The home had a registered manager and management checks had improved since the previous inspection. Staff said they felt listened to and supported.
“At the last inspection, there had not been a registered manager in post, but there was now.” from the report
Staffing flexibility
seriousA recent increase in incidents involving distress made it harder for staff to monitor people at risk of falls while supporting others. Inspectors recommended reviewing staffing plans and deployment.
“We recommend the provider review the planning and deployment of staffing levels, to ensure people receive consistently safe and responsive care.” from the report
Medicines records
minorMedicines were generally managed safely, but some 'as required' instructions and people's profiles needed to be clearer and more consistent.
“We pointed out a few minor areas to be reviewed to ensure records were clear and consistent, such as information in 'as required' medicines protocols or people's profiles.” from the report
Premises checks and repairs
needs fixingInspectors identified some safety checks that needed review and some repairs that needed attention. The registered manager said these would be dealt with promptly.
“We pointed out a few checks that required review as well as some repair needs to the registered manager.” from the report
Opportunities to go out
minorActivities were mainly provided one to one because many people did not enjoy group activities. Inspectors identified going out as an area for development while the garden was being improved.
“We considered with the registered manager that going out for people was an area for development, from feedback we saw.” from the report
- 01How many staff are on each shift now, and how do you increase staffing when people become distressed or need closer monitoring?
- 02Have all the medicines-record issues identified by inspectors been corrected, especially the 'as required' instructions and people's profiles?
- 03Which safety checks and repairs were identified during the inspection, and have they all been completed?
- 04What opportunities are now available for residents to go out or use the garden safely?
- 05How do you check that care remains personalised when only two staff are on a shift?
This was a planned, unannounced inspection covering all five key questions, including the premises and care provided; the inspection reviewed two care records, two staff files and multiple medicines records. This explanation was written from the published report of 9 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, February 2017
Rated Good overall; inspectors found kind, safe care, but the home needed to improve medicines checks and management arrangements.
This was an unannounced inspection on 6 January 2017. One inspector spoke with four people living in the home, one relative and three care staff. They observed care and checked care records and management records.
The home was rated Good for being safe, effective, caring and responsive. People were protected from abuse, there were enough staff, medicines were usually given as prescribed, and people received suitable food, activities and healthcare.
The well-led rating was Requires Improvement. The home did not have a registered manager, and medicines audits did not always give an accurate record of medicines brought into the home. The manager said a new system would be introduced.
Safe care
Staff understood safeguarding and individual risks. Inspectors saw staff supporting people patiently and taking steps to reduce risks such as falls and sore skin.
“People were safe and protected from harm and abuse and staff knew how to act if they had any concerns.” from the report
Kind and respectful staff
Staff knew people well and supported their choices, privacy and dignity. People were able to choose matters such as when to go to bed and whether to join activities.
“People were treated with dignity and respect and were supported to express their views about their care; their views were listened to and acted upon.” from the report
Improved decision-making support
The home had improved how it supported people who could not make particular decisions. Assessments and best-interest decisions were recorded, and applications were made where liberty was restricted.
“On this inspection we found improvements had been made.” from the report
Personalised care and activities
Care plans included people's likes, dislikes and preferred support. People could choose how to spend their time and were supported with hobbies, faith and family contact.
“People chose how to spend their time and what to be involved with.” from the report
Medicines records
seriousAudits did not always record medicines received when people returned from hospital or were unwell. This meant checks might not show whether people had received medicines as prescribed.
“This meant checks would not identify whether people had their medicines as prescribed.” from the report
No registered manager
needs fixingThere was a manager working in the home, but no registered manager was in post at the inspection. The manager was completing an application to register.
“The service did not have a registered manager although there was a manager working in the service.” from the report
Formal staff supervision
needs fixingStaff could speak to the manager, but staff said they did not have regular formal supervision. This was identified as an opportunity to discuss how they were doing and what support they needed.
“Staff told us they did not participate in regular formal supervision to support them in their role.” from the report
- 01Has the new medicines recording system been introduced, and how do you now check medicines received after hospital stays or during illness?
- 02Has the manager's application to become the registered manager been completed?
- 03How often do staff now receive formal supervision?
- 04How are capacity assessments and best-interest decisions kept up to date when a person's ability to make decisions changes?
- 05How is staffing reviewed when people's needs change or there are absences?
This was an unannounced inspection of the overall service, covering all five rating areas; the report also records that the previous inspection's consent concerns had improved. This explanation was written from the published report of 14 February 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 Dover Cottage Rest Home
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- August 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- September 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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