CQC report explained · a residential care home
What the CQC found at Duke's Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and neglect. Risks were assessed and managed, medicines were recorded safely, infection controls were in place and there were enough suitable staff.
- Effective?
- Good
- Care was based on people's needs and choices. Staff were trained, people were supported with eating and drinking and healthcare, and consent and best-interest processes were followed.
- Caring?
- Good
- No separate Caring rating was given in this report.
- Responsive?
- Good
- No separate Responsive rating was given in this report.
- Well-led?
- Good
- Managers and staff were described as approachable and supportive. Improved audits and quality checks helped identify and address risks and areas for improvement.
What inspectors found, August 2023
Rated Good; inspectors found safe, effective and well-led care, with clear improvements since the previous inspection.
Inspectors visited the home without warning on 9 May 2023. They spoke with 8 people, 11 relatives, staff, managers and a visiting professional. They reviewed care files, medicines records, recruitment checks and quality monitoring records.
The home was rated Good overall. Safe, Effective and Well-led were all rated Good. Inspectors found people were protected from abuse, risks were assessed, medicines were managed safely and there were enough suitable staff.
People received care based on their needs and choices. Staff were trained and supported, people were helped with food, drink and healthcare, and the home followed the Mental Capacity Act. The home was clean, well maintained and had improved its quality checks.
The previous rating was Requires Improvement, published in July 2022. The provider had been in breach of Regulations 12 and 17 at that inspection, but inspectors found enough improvement and said the home was no longer in breach.
Safe medicines and risk management
Inspectors found that risks to people's health and safety were assessed and managed. Medicines records were completed and signed appropriately.
“Medicines were managed well. People were supported by staff who followed systems and processes to order, administer, record and store medicines safely.” from the report
Trained and consistent staff
There were enough staff, recruitment checks were completed and staff received induction, training, supervision and appraisals. The home had allocated staff to the same areas to improve consistency.
“There were enough staff in place to provide safe care and treatment.” from the report
Choice and consent
Staff asked for consent, offered people choices and followed best-interest processes where people lacked capacity. DoLS arrangements were appropriately completed where needed.
“We heard staff asking people for their consent before assisting them and offering people choices about how and where to spend their day.” from the report
Improved management oversight
The provider and registered manager had introduced regular audits and reviewed actions when issues were found. This was a clear improvement from the previous inspection.
“Improved quality monitoring and auditing systems had meant the provider and registered manager had made improvements in all areas which we highlighted during our previous inspection.” from the report
Positive experience of care
People and relatives spoke positively about the care. Inspectors observed staff supporting people patiently at lunchtime and helping them with eating when needed.
“The staff make me feel really cared for.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure the same staff continue to support people in the same area of the home?
- 02How are the daily, weekly, monthly, quarterly and annual audits reviewed, and how quickly are actions completed?
- 03How do you monitor food and fluid intake for people at risk of malnutrition or dehydration?
- 04How does the virtual team of nurses and clinicians support residents when their health needs change?
- 05How will you support my relative's religious, cultural and other personal choices in their care plan?
This inspection rated Safe, Effective and Well-led; it did not give separate ratings for Caring or Responsive, and it also included checks of infection prevention and control. This explanation was written from the published report of 11 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, July 2022
Duke's Court Care Home is rated Requires Improvement; inspectors found risks with medicines, injuries, fire safety and management systems.
This was an unannounced focused inspection on 26 April 2022. Inspectors looked only at Safe and Well-led because of concerns about falls, bruising, medicines, staffing and personal care. They spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
The home was not consistently safe. Inspectors found problems with medicines records, injury monitoring, choking risks, falls assessments, fire doors and window restrictors. Recruitment checks and ongoing checks on staff suitability also needed improvement.
The home was not consistently well-led. Internal checks had failed to identify several safety and care-record problems, and actions did not always have target dates. However, people said they felt safe, staff were kind and respectful, the home was clean, and people and relatives were involved in care planning.
The overall rating changed from Good at the previous inspection, published in January 2018, to Requires Improvement. This inspection did not assess Effective, Caring or Responsive, so the previous ratings for those areas were carried forward when calculating the overall rating.
Clean and infection control
The home was clean and odour free. Staff used protective equipment properly and the provider followed COVID-19 visiting guidance.
“People were protected from the risk of infection and the home was clean and odour free.” from the report
Respectful relationships
People appeared comfortable with staff. Inspectors found positive relationships and said people's independence was respected.
“People appeared relaxed and comfortable around staff.” from the report
Personalised care
Care plans included people's preferences and important relationships. People were supported to take part in individual and group activities.
“Care plans reflected people's choices preferences, religion, culture and relationships that were important to them.” from the report
Involvement and openness
People and relatives were involved in care planning and were asked for feedback. The provider responded in writing when things went wrong.
“The provider had responded in writing to people, and those important to them, when things went wrong.” from the report
Medicines
seriousStaff did not always have clear instructions for medicines given when needed. Reasons for giving these medicines were not always recorded, so their effectiveness could not be checked.
“People were at potential risk of not receiving their medicines as prescribed.” from the report
Injuries, falls and choking
seriousInjury records were incomplete, falls risks were not always reassessed promptly, and records about thickened drinks were conflicting. This created risks that injuries, falls or choking would not be managed properly.
“This put people at risk of harm from unmanaged injuries, and the potential risk of deterioration of injuries.” from the report
Fire and window safety
seriousSeveral fire doors were not working effectively. Window restrictors were not tamper proof, increasing the risk of a fall from height.
“This meant there was an increased risk of fire spreading should a fire break out in the home.” from the report
Management oversight
seriousInternal audits had not identified important safety, medicines and care-plan problems. Equipment checks and action tracking were also not consistently in place.
“The provider had failed to ensure adequate systems and processes were in place to assess, monitor and improve the quality and safety of the care provided.” from the report
Recruitment checks
needs fixingA gap in one staff member's employment history had not been explored. There was also no system for checking staff convictions and cautions on an ongoing basis.
“However, when a staff member had a gap in their employment history this had not been explored” from the report
- 01What action has been taken to ensure as-required medicines have clear instructions and that the reason for each dose is recorded?
- 02How are injuries now recorded, followed up and reviewed for patterns?
- 03What has been done to reassess falls risks, check sensor mats and make the fire doors and window restrictors safe?
- 04How do you now check that care plans and safety records are complete and that improvements have target dates?
- 05What ongoing checks are now made on staff employment histories, convictions and cautions?
This was an unannounced 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 16 July 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 Duke's Court Care Home
4 rated inspections over 8 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2022Inspected but not ratedSafe: Inspected but not rated
- February 2021Inspected but not ratedSafe: Inspected but not rated
- January 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014
Registered with the Care Quality Commission on 22 December 2014.
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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