CQC report explained · a nursing home
What the CQC found at Dover House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2023
Willow Park Lodge was rated Requires Improvement; inspectors found kind, responsive care, but safety records and management checks were not reliable enough.
This was an unannounced inspection over 6 and 8 December 2022. Inspectors spoke with 13 people, 12 relatives and 13 staff. They also observed care, checked records and reviewed medicines, recruitment, training, audits and safety checks.
People and relatives generally said they felt safe and treated with kindness. Inspectors found enough staff, safe medicines management, good support with food and healthcare, and care that respected people's dignity, choices and independence.
However, some risk assessments and care notes did not give staff enough guidance. Records of checks, fluid intake, repositioning and oral care were inconsistent. Audits did not always lead to completed actions, and the management structure and communication were not always clear.
The overall rating and the ratings for Safe and Well-led were Requires Improvement. Effective, Caring and Responsive were rated Good. This was the first inspection of the newly registered service, although the previous provider had also been rated Requires Improvement in November 2021.
Kind and respectful care
People and relatives described staff as caring and respectful. Inspectors saw staff offering reassurance, choices and support in a dignified way.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Safe medicines
Medicines were stored, given and recorded safely. Staff administering medicines had been trained and assessed as competent.
“Medicines were managed safely in line with national guidance.” from the report
Enough staff
Rotas showed that planned shifts were filled, and inspectors found enough staff to meet people's needs. Recruitment checks had also been completed.
“There were enough staff deployed to meet peoples' needs.” from the report
Personalised activities
The home offered activities suited to people's interests, including knitting, music and film sessions. Community outings were also being introduced.
“Activities were personalised for people.” from the report
Good food and healthcare support
People's dietary needs and preferences were recorded and supported. Staff worked with doctors, therapists, dieticians and specialist nurses when needed.
“People were supported to eat and drink enough.” from the report
Incomplete risk information
seriousSome risk assessments did not explain clearly enough how staff should support people, including with falls, choking or skin damage. This could make care less consistent and increased the risk of harm.
“Risk assessments did not always contain enough information for staff to provide safe care and manage any risks, such as falls, choking or skin damage.” from the report
Inconsistent care records
seriousRecords of hourly checks, fluid intake, repositioning, mattress checks and oral care were not always complete or accurate. The manager could not always be sure that planned care had been provided.
“The registered manager could not be assured care and support had been provided in accordance with people's plans.” from the report
Weak follow-through on audits
needs fixingThe home had audits and action plans, but actions were not always completed or monitored. New processes had not yet become established in everyday practice.
“Where shortfalls had been found during audits, action plans had not been fully completed or monitored.” from the report
Unclear management communication
needs fixingHealthcare professionals sometimes struggled to reach the right person or receive clear information about who was responsible. The management structure was not always clear to people and visitors.
“Another professional expressed concerns about communication and lack of clarity about who to communicate with.” from the report
Complaint outcomes not always clear
minorComplaints were investigated, but resolutions were not always recorded or explained clearly enough. It was not always clear whether people were satisfied with the outcome.
“However, resolutions were not always documented or communicated, and it was not always clear whether people were satisfied with the outcome.” from the report
- 01How have you improved risk assessments for falls, choking and skin damage, and how do you check that staff follow them?
- 02What checks now make sure hourly observations, fluid intake, repositioning, mattress checks and oral care are recorded accurately?
- 03How do you make sure actions from medicine and other quality audits are completed and monitored?
- 04Who is the main person for relatives and healthcare professionals to contact, and how is this communicated to everyone?
- 05How are complaint outcomes now recorded and explained to the person who raised the concern?
This was an unannounced first inspection of the newly registered care home and assessed all five key questions, including infection prevention and control. This explanation was written from the published report of 22 February 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.
Every inspection of Dover House
5 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Requires improvement
- November 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2020Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2018GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022
Registered with the Care Quality Commission on 5 July 2022.
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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39 live-in carers within about an hour of Kent
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Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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