CQC report explained · a residential care home
What the CQC found at The Dairy House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risk assessments, safeguarding systems, medicine checks, safety checks and infection-control arrangements were in place, although some 'as required' medicine protocols needed more detail.
- Effective?
- Good
- Staff were trained and supported, and people received suitable health care, food and equipment. Some staff had not yet been trained to use a person's walking equipment, and some mental capacity assessments were not decision-specific.
- Caring?
- Good
- Relatives described staff as kind, caring and patient. Inspectors saw positive relationships and support for choice and independence, but observed occasions when staff did not knock or seek consent before providing support.
- Responsive?
- Good
- Care plans included people's needs, preferences and activities, and staff used communication aids to support choice. Some plans needed more detail, and physiotherapy plans were not always followed or recorded consistently.
- Well-led?
- Good
- The home had approachable leadership, regular audits and systems for learning from incidents and feedback. Relatives and staff were involved in reviews, surveys and discussions about improvements.
What inspectors found, May 2019
Rated Good, down from Outstanding; inspectors found kind, person-centred care with some records and staff-consistency issues.
Inspectors visited on 18 and 19 March 2019. The first day was unannounced and the second was announced. They observed care, reviewed three care plans and checked staffing, training, medicines, incidents and quality records. They also spoke with staff, managers, health professionals and five relatives.
The home supported 15 adults with learning disabilities, autism and/or physical disabilities. Inspectors found people were safe, treated kindly and supported to make choices, stay independent and take part in activities and the local community. Medicines, staffing levels, infection control and safeguarding systems were generally effective.
There were some areas to improve. Some 'as required' medicine instructions needed more detail. Mental capacity assessments were not always specific to each decision. There were also gaps involving consent, some care-plan information, physiotherapy records and training for new staff. The overall rating and each of the five areas were Good.
Choice and independence
People were supported to make day-to-day choices, communicate in their preferred ways and do as much as possible for themselves. Staff encouraged participation in the community and activities people enjoyed.
“During the inspection we found people were given choices and their independence and participation within the local community was encouraged.” from the report
Kind and respectful relationships
Relatives described staff as caring and patient. Inspectors observed positive interactions and found that people appeared comfortable with staff.
“Relatives told us staff were kind, caring and committed to their work.” from the report
Good health support
Staff monitored people's health, acted when people were unwell and worked with health professionals. Staff also had access to specialist support from professionals including physiotherapy and speech and language therapy.
“Staff supported people to have good health care support from professionals.” from the report
Activities and communication
People had individual activity schedules and access to college, community activities, holidays, hydrotherapy and other interests. Assistive technology helped people communicate and make choices.
“People engaged in activities of their choosing.” from the report
Open management
Relatives and staff said managers were approachable and listened to concerns. Audits, surveys and meetings were used to monitor and improve the service.
“There were systems in place to monitor and improve the quality of care and support provided.” from the report
Medicine instructions
needs fixingSome instructions for medicines given only when needed did not explain clearly enough when staff should give them or the maximum dose. The manager said these protocols would be updated.
“The protocols in place for some of the PRN medicines required more details.” from the report
Mental capacity records
needs fixingSome assessments did not relate clearly to one particular decision, as required by the relevant guidance. The provider was recommended to revisit its approach.
“We found some of the MCA assessments were not decision specific, which is in line with the MCA Code of Practice.” from the report
Staff consistency and specialist training
needs fixingRelatives reported a high turnover of staff. Some new staff had not been trained to use specialist walking equipment, and this contributed to physiotherapy plans not always being followed consistently.
“Due to the recent employment of new staff, some staff had not received training in supporting people with specific activities.” from the report
Care-plan detail
minorSome communication, food-texture and physiotherapy information was unclear or incomplete. The manager said these points would be addressed.
“Some of the care plans required further details to fully explain people's support needs.” from the report
- 01What has been changed in the 'as required' medicine protocols, including instructions about when to give medicines and maximum doses?
- 02How are mental capacity assessments now linked to each specific decision, and how are people supported to make those decisions?
- 03How do staff seek consent and protect privacy before entering rooms or providing personal care?
- 04How are new staff trained to use specialist walking equipment and follow each person's physiotherapy plan?
- 05What is being done to reduce staff turnover and provide greater consistency for residents?
This was a planned inspection covering all five CQC questions and both the premises and care provided; the previous rating was Outstanding in September 2016. This explanation was written from the published report of 1 May 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 Outstanding; inspectors found kind, personalised care with especially strong activities, leadership and quality monitoring.
The inspection was unannounced and took place on 21 April 2016. One inspector observed care, spoke with staff and visitors, and reviewed care, medicines, safety and quality records. There were 15 people living at the home, although one was in hospital.
Inspectors found enough staff, safe medicines systems and good safeguarding arrangements. Staff were trained, knew people well and supported their health, nutrition, choices and independence.
Care was described as kind and respectful. The home used personalised communication, flexible routines and creative technology to help people take part in activities and make choices. Inspectors rated Responsive and Well-led Outstanding.
The overall rating of Outstanding means the home was judged to provide exceptionally good care overall at that inspection. Safe, Effective and Caring were rated Good. The previous inspection on 6 February 2014 had found no concerns with the care provided.
Personalised activities
People were supported to follow individual interests and take part in activities at home and in the community. Staff also responded to spontaneous requests rather than relying only on planned activities.
“People were fully supported in innovative ways to follow their interests and take part in social activities.” from the report
Kind and respectful care
Inspectors saw warm relationships between staff and people. Staff supported privacy, dignity, choice and independence.
“Staff were kind and professional. People were treated with dignity and respect.” from the report
Creative communication
The home used communication training, communication profiles and assistive technology to help people express choices and engage with others.
“The service was using and exploring innovative ways to help them communicate with people and to ensure people lived a full and happy life.” from the report
Strong leadership and improvement
The manager was visible and well supported. Audits, staff feedback and surveys were used to monitor care and make improvements.
“There was an effective quality assurance programme in place which monitored the quality and safety of the service and drove improvements.” from the report
Safe medicines
Medicines were securely stored and administered by trained staff. Records showed medicines had been given or appropriate entries had been made when they were not given.
“People received their medicines when they needed them.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently support people who communicate without speech, and which communication tools or technology do you use?
- 02How are staffing levels decided for people who need one-to-one support, including during the night?
- 03How do you make sure new staff are trained and assessed as competent before supporting each person?
- 04How are care plan reviews arranged so that each person can choose where the review happens and who attends?
- 05How do you record and follow up changes in people's needs, such as falls, anxiety or difficulties with mobility?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 6 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 The Dairy House
2 rated inspections over 3 years: the service has slipped, from Outstanding to Good.
- May 2019Goodcurrent ratingdown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 2011.
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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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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