CQC report explained · a residential care home
What the CQC found at The Dales Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Care, medicines, infection control and staffing had improved. However, some risk assessments were not maintained, and not all actions were taken when risks were identified.
- Effective?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Well-led?
- Requires improvement
- Management systems had improved but were not consistently maintained or applied. The home remained in breach of Regulation 17 on good governance.
What inspectors found, March 2022
Rated Requires Improvement; care and safety had improved, but fire safety and management checks still needed attention.
This was an unannounced, focused inspection on 2 February 2022. Inspectors checked whether the home had followed its improvement plan after an earlier inadequate rating. They spoke with five people, two relatives and ten staff, and reviewed care, medicines, recruitment and other records.
The home had improved since the last inspection. Care plans were more personal and included people's needs, preferences and risks. Medicines, infection control, the environment and staffing levels were generally managed safely. Inspectors also saw kind and respectful interactions between people and staff.
The home was still not consistently well managed. Some risk checks and checks on agency staff had not been kept up to date. Fire doors were being wedged open, and one unsafe area remained accessible. The home remained in breach of Regulation 17 on good governance.
The overall rating improved from Inadequate to Requires Improvement. The home was no longer in special measures, but the new rating means further improvement is needed and CQC will continue to monitor it.
Kind relationships
Inspectors saw friendly and thoughtful interactions. People and relatives said they liked the home.
“There was a friendly and relaxed atmosphere at the home. We observed many kind, friendly and thoughtful interactions between people living at the home and staff members.” from the report
Personal care planning
Care plans included what mattered to people, their needs and their risks. This gave staff current information about how to support them.
“People's care plans now identified what was important to them, along with their needs and any risks in their care.” from the report
Medicines and infection control
Medicines were stored, recorded and given safely. The home was clean, staff used protective equipment properly, and COVID-19 measures were in place.
“People's medicines were stored, recorded and administered safely.” from the report
Improved environment
Parts of the home had been refurbished and inspectors found the environment pleasant and clean. Maintenance and safety checks were taking place.
“Areas of the home had been refurbished and the home's environment was pleasant and clean.” from the report
Fire doors
seriousStaff were still wedging open bedroom fire doors. Inspectors said this stopped the doors closing automatically to protect people during a fire.
“At this inspection staff were still in the practice of wedging open the fire doors on people's bedrooms.” from the report
Governance systems
needs fixingSome systems for checking quality and safety were not consistently maintained or used effectively. This was the reason the home remained in breach of Regulation 17.
“Systems for assessing and monitoring the quality and safety of the service had not been consistent or always applied effectively.” from the report
Agency staff checks
needs fixingThe home could not always be sure that agency staff were suitable and working safely because the checking system had not been maintained. It was corrected on the inspection day.
“However, this system had become disorganised and had not been maintained. This was rectified on the day of our inspection.” from the report
Access to an unsafe area
seriousOne area was accessible to people even though it was not safe for them to use. Staff knew about the risk but had not dealt with it.
“One area of the home was accessible to people when it was not safe for them to do so.” from the report
- 01What has been done to stop bedroom fire doors being wedged open, and how is this now checked?
- 02How have you secured or restricted access to the area that inspectors found was unsafe?
- 03How do you now check that agency staff have the right skills, training and safety checks?
- 04What action plan has been sent to CQC to address the Regulation 17 breach?
- 05How will you show that risk assessments and quality checks are being kept up to date?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 22 March 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.
What inspectors found, July 2021
Rated Inadequate and placed in special measures; inspectors found serious risks involving safety, infection control, safeguarding and management.
This was an unannounced focused inspection on 10 and 16 June 2021. Inspectors looked only at whether the home was safe and well-led. They spoke with people, relatives, managers and staff, and checked care records, medicines records, recruitment files and management records.
Inspectors found serious problems. Risks were not properly assessed or followed up. Safeguarding concerns, accidents and incidents were missed. The home was visibly dirty and smelled strongly of urine. Infection control arrangements did not follow government guidance, and some staff had been recruited without references.
The home’s records and quality checks were poor. The registered manager and acting manager did not have enough oversight of the service. Inspectors identified breaches of four regulations and changed the overall rating from Requires Improvement to Inadequate.
The provider sent an urgent action plan and made some quick changes during the second inspection visit. However, the home was placed in special measures. CQC said it would monitor progress and normally re-inspect within six months.
Kind staff and enough staff
Inspectors found enough staff on duty during the visit. Staff were observed to be kind and caring.
“There were enough staff on duty to support people. Staff were observed to be kind and caring.” from the report
Communication with relatives
Relatives reported good communication with the home, including during COVID-19 lockdowns.
“Relatives told us that they had good communication with the home and that throughout the past difficult year and COVID-19 lockdowns, this had been invaluable.” from the report
Risks and safeguarding were missed
seriousCare records did not give staff enough accurate guidance about people’s needs and risks. Accidents, incidents and safeguarding concerns were not consistently recorded or acted on, putting people at risk of harm.
“Care plans did not contain adequate information or guidance for staff about people's needs, risks or the care they required in order to ensure their health and safety was maintained.” from the report
Poor cleanliness and infection control
seriousThe home was visibly dirty and strongly smelled of urine. COVID-19 testing, visitor guidance and the disposal of used protective equipment did not consistently follow guidance.
“The home was visibly dirty. It smelled very strongly of urine in almost every part of the home.” from the report
Weak management and records
seriousManagers did not have effective systems to check care, risks, cleanliness or the condition of the home. Records were incomplete, inaccurate and not always up to date.
“The governance arrangements in place were not robust, managerial oversight was poor and record keeping was not always adequately maintained.” from the report
Recruitment checks
seriousTwo staff recruited in the previous six months had no references recorded. Inspectors said people could be at risk from staff who might not be suitable for the role.
“Safe recruitment practices had not been followed and people were at risk from staff who may be unsuitable for the role.” from the report
People’s choices
needs fixingThe report said people were not always supported to make choices about their daily routines, including what time they got up.
“People were not supported to have maximum choice and control of their lives and staff did not support them to make choices about what time they got up each morning.” from the report
- 01What has been done to assess and monitor each person’s risks, including falls and other safeguarding concerns?
- 02How do you now make sure accidents, incidents and safeguarding concerns are recorded, investigated and acted on?
- 03What evidence can you show that the home is clean, that urine smells and damaged carpets have been dealt with, and that infection control follows current guidance?
- 04How are care records and management audits checked now, and who has responsibility for oversight of the home?
- 05Have all staff recruitment files been checked for references, and how are agency staff inducted and supervised?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 16 July 2021 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 Dales Care Home
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
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