CQC report explained · a residential care home
What the CQC found at The Dell Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Care plans and risk assessments clearly explained how risks were managed and were updated when people's needs changed. Medicines, safeguarding, infection control and recruitment arrangements were also found to be safe.
- Effective?
- Good
- This question was not rated in this inspection.
- Caring?
- Good
- This question was not rated in this inspection.
- Responsive?
- Good
- This question was not rated in this inspection.
- Well-led?
- Good
- Quality monitoring had improved and was identifying and addressing shortfalls. The registered manager had left shortly before the inspection, but regional management was overseeing the home while a replacement was being recruited.
What inspectors found, March 2023
Rated Good; inspectors found safe care and improved oversight, but management continuity was still a concern.
The inspection was unannounced and took place on 09 February 2023. One inspector visited the home, while an expert by experience telephoned people and relatives. Inspectors spoke with one person, 12 relatives and five staff, and reviewed care, recruitment and quality records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that risk assessments and care plans were now clear and updated when people's needs changed. Medicines were stored and given safely, staffing was sufficient on the inspection day, and recruitment checks were in place.
The home had improved since its previous Requires Improvement rating in July 2021. Management changes and the recent departure of the registered manager remained a concern, but inspectors found that regional oversight and quality checks were helping to maintain standards.
Clearer risk planning
Care plans and risk assessments gave staff clear information about people's risks and support needs. They were updated when needs changed.
“Care plans and risk assessments now clearly set out how risks were managed, and the care people required to remain safe.” from the report
Safe medicines
Medicines were stored and administered safely. The electronic system was checked daily and medicines audits were used to address shortfalls.
“Medicines were managed, administered and stored safely.” from the report
Quality checks led to improvements
The home had a quality assurance system that identified areas needing improvement, including care planning. Inspectors saw evidence that action had been taken.
“There was a comprehensive quality assurance system in place which was capable of identifying areas for improvement.” from the report
People's views were used
People and relatives could attend meetings and complete surveys. Inspectors saw evidence that feedback, including comments about food, had led to action.
“We saw that the responses to the last survey were largely positive and some comments around the quality of food had been acted upon.” from the report
Management turnover
needs fixingThe registered manager had left shortly before the inspection, and people reported a lack of continuity because of frequent management changes. A replacement was being recruited.
“Feedback about the management of the service was mixed because of the high turnover of registered managers.” from the report
Past staffing concerns
minorFeedback about staffing was mixed. Most relatives felt current staffing was sufficient, but some concerns related to staffing problems during and after the COVID-19 pandemic.
“There was mixed feedback about whether there were sufficient staff to meet people's needs.” from the report
- 01Who is currently responsible for the home while a new registered manager is being recruited?
- 02How will you maintain continuity for residents during changes in registered managers?
- 03How do you calculate the staffing level for each shift, and what happens if staff numbers fall short?
- 04How are risk assessments and care plans checked and updated when a resident's needs change?
- 05What recent improvements have your quality audits identified, and how have you acted on them?
This inspection focused on progress with previous shortfalls and covered Safe and Well-led; the other three key questions were not rated in this report. This explanation was written from the published report of 7 March 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, August 2021
Requires Improvement; inspectors found safe staffing, medicines and kind care, but important risks and management arrangements were not consistently controlled.
This was an unannounced focused inspection on 7 June 2021. One inspector visited the home, and an expert by experience telephoned relatives. Inspectors spoke with two people, seven relatives and six staff, and reviewed care, medicines, staff and management records.
The home was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement. Risk plans did not always explain how people should be protected, and records did not always show that care had been provided as planned. Management had been inconsistent, partly because one registered manager was covering three services.
Inspectors also found positive areas. There were enough staff, medicines were managed safely, infection control arrangements were in place, and staff were kind and caring. The previous rating was Good in 2018, so the ratings for Safe and Well-led had deteriorated.
Safe medicines
Inspectors found that medicines were managed and given safely, with information about people's preferences and as-needed medicines available to staff.
“Observations, an audit of medicine stocks and records assured us that medicines were managed and administered safely.” from the report
Enough staff
Inspectors saw enough staff available to support people when needed. Staff had time to talk with people and provide activities.
“We observed that there were sufficient numbers of staff to provide people with support at the time they needed it.” from the report
Kind and caring staff
Staff were described and observed as kind, caring and friendly. Inspectors found that staff knew people as individuals.
“They were kind, caring and friendly to people using the service and clearly knew them as individuals.” from the report
Activities and improvements
The home had invested in activities, equipment and improvements to the environment. Inspectors saw activity staff engaging people and noted a pleasant atmosphere.
“During our inspection three activities staff were available and engaging people.” from the report
Risk plans were not clear enough
seriousSome care plans did not explain clearly how staff should reduce risks, including the risk of pressure ulcers. This meant inspectors could not be assured that people were consistently protected.
“pressure ulcer care plans did not set out what preventative measures were in place where people had been assessed as at very high risk of a pressure ulcer.” from the report
Care records did not always show care was completed
seriousRepositioning charts did not always show that people had been moved as often as their care plans required. This could increase the risk of skin breakdown.
“these did not evidence that people were being repositioned in line with the frequency stated in their care plan.” from the report
Inconsistent management
needs fixingThe registered manager was responsible for three services, and inspectors were unclear about where they would be based. This reduced assurance about consistent management of the home.
“We were not assured of how the provider was ensuring consistent ongoing management of The Dell Care Home.” from the report
Poor communication with relatives
needs fixingRelatives said they received little information about how their family members were doing and did not always know who to contact.
“They stated that with all the changes in management, they received little information or contact from the service about how their relative was, how they were spending their time.” from the report
- 01How are you now recording and reviewing measures to prevent pressure ulcers?
- 02How do you check that repositioning and other care interventions have been completed as set out in care plans?
- 03Who is the day-to-day manager of the home, and how often are they present?
- 04Who should relatives contact with concerns, and how will families receive regular updates?
- 05What actions have been completed in response to the Requires Improvement ratings?
This was a focused inspection of Safe and Well-led only, including infection prevention and control; the other three question ratings were not assessed. This explanation was written from the published report of 3 August 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 Dell Care Home
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2018Goodstayed GoodSafe: GoodWell-led: Good
- February 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- May 2015
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 25 February 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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