CQC report explained · a residential care home
What the CQC found at Dunsland House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, risks were assessed and reviewed, and staff understood how to respond to safeguarding concerns. Medicines, infection control, equipment and recruitment were managed safely, although some people reported waiting for call bell responses at times.
- Effective?
- Good
- Care plans reflected people's needs, choices and independence. Staff received relevant training and support, and people were supported with food, drink, healthcare and lawful decision-making.
- Caring?
- Good
- People and relatives were positive about the care. Staff treated people with kindness, protected their privacy and dignity, and involved them in decisions about their care.
- Responsive?
- Good
- Care plans were personalised and people could choose activities and how they spent their time. Complaints were recorded and responded to appropriately. The home was not supporting anyone with end of life care at the time.
- Well-led?
- Good
- The manager was visible, approachable and knowledgeable. Staff worked as a team, and audits, meetings and feedback were used to monitor and improve the service.
What inspectors found, June 2019
Rated Good; inspectors found kind, safe and well-managed care, although some people sometimes waited for a response to their call bells.
This was an unannounced planned inspection on 28 May 2019. One inspector spoke with four people, one relative and four staff. They reviewed two care files, staff records, medicines and records about incidents, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were treated with kindness, dignity and respect. Staff knew people well, and care plans recorded their choices and preferences.
Inspectors found safe medicines management, suitable staff recruitment, personalised care, activities and good links with health professionals. The manager was visible and approachable, and the home had systems to check quality and act on issues.
The main limitation noted was that people sometimes had to wait for staff to respond to their call bells, although inspectors found that people were not put at risk and their needs were met in a timely way during the visit. The previous inspection in 2016 also rated the home Good.
Staff knew people well
People were supported by a consistent staff team who understood their needs, preferences and routines.
“People were happy at the service and were supported by staff who knew them well.” from the report
Safe medicines
Staff were trained and checked as competent to give medicines. Inspectors saw medicines being given discreetly and respectfully.
“People received their medicines when they needed them. We saw staff administering medicines in a discreet and respectful manner.” from the report
Personalised care
Care plans recorded people's choices, abilities, likes and dislikes. People were encouraged to remain independent and make decisions.
“People's care plans were personalised and set out how people liked to be supported to meet their individual needs and preferences.” from the report
Kind and respectful care
Staff protected people's privacy and dignity and involved people and relatives in care reviews and decisions.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Strong management
The manager was visible and approachable. The home used audits, meetings and feedback to identify and address issues.
“The registered manager used their governance systems to help them identify and resolve any issues in the home.” from the report
Call bell response times
minorSome people said they sometimes had to wait for staff to respond to their call bells. Inspectors found that people were not put at risk and needs were met in a timely way during the inspection.
“People told us that at times in the day they had to wait for response from staff to their call bells, however, they were not put at risk.” from the report
- 01How quickly do staff usually respond to call bells, especially at busy times of day?
- 02How do you review staffing levels when people's care needs change?
- 03What arrangements would you make if a resident needed end of life care?
- 04How are residents' views used when planning activities and reviewing their care plans?
- 05How will you monitor and address any delays in responding to call bells?
This was an unannounced planned inspection covering all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 11 June 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, September 2016
Rated Good overall; inspectors found safe, kind and personalised care, but staff appraisals and some risk records needed improvement.
Inspectors visited the home without warning on 4 and 6 July 2016. They spoke with people living there, relatives, staff and managers. They observed care and checked care plans, medicines, recruitment, training and quality checks.
The home was rated Good for safety, caring, responsiveness and leadership. Inspectors found medicines were managed safely, staff understood safeguarding, care was kind and respectful, and care plans reflected people's needs and preferences.
The home was rated Requires Improvement for effectiveness. Staff training and supervision were in place, but there was no evidence that staff appraisals had been completed. The manager said appraisals had started after the inspection.
The overall Good rating means inspectors judged the care to be good in most areas, but not consistently excellent. This was the first inspection of the home.
Safe medicines
Inspectors checked medicines for five people and found they were given as prescribed, stored safely and recorded without unexplained gaps.
“We looked at the medicine administration records (MAR) for five people and found that these had been completed correctly, with no unexplained gaps.” from the report
Kind and respectful care
Staff were friendly and supportive. Inspectors saw people being treated respectfully, with privacy and dignity protected.
“Staff were friendly, kind and caring towards the people who lived at the home.” from the report
Personalised support
Care plans included people's histories, preferences, communication, health needs and interests. People and relatives were involved in reviews.
“People's care plans also held information about their links with the community and any advance decisions they may have made.” from the report
Visible leadership
The provider and manager were regularly present and approachable. The home had monthly quality checks covering areas such as medicines, infection control and care records.
“The provider had a quality assurance system in place.” from the report
Staff appraisals were missing
needs fixingThere was no evidence that staff performance appraisals had been completed. The manager said these would be completed before the end of 2016, and later sent evidence that the process had started.
“However, there was no evidence to show that appraisals of staffs' performance were carried out.” from the report
Some risk reviews were overdue
needs fixingSeveral health and safety risk assessments had passed their recommended review dates. The manager took action and sent updated assessments two days after the inspection.
“We found that these risk assessments needed to be updated as the recommended review dates had passed.” from the report
Refurbishment reduced communal access
minorRefurbishment meant people could not use parts of the ground floor, including the dining area, during the inspection. The area was closed off safely and the work was nearing completion.
“This refurbishment work had impacted on people's care and support because they did not have access to the areas of the home that were being redecorated” from the report
- 01Have all staff now had a completed performance appraisal, and how are the outcomes followed up?
- 02How often are the home's health and safety risk assessments reviewed, and how do you make sure none become overdue?
- 03Has the refurbishment been completed, and can residents now use all communal areas, including the dining area?
- 04What staffing arrangements are in place for activities outside the home?
- 05Has an activities co-ordinator been appointed, and what regular activities are now available?
This was an unannounced first inspection covering all five CQC questions, with visits on 04 and 06 July 2016. This explanation was written from the published report of 2 September 2016 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 Dunsland House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2015
Registered with the Care Quality Commission on 30 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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