The Dales Care Home

Updated 22 March 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by two inspectors.

Service and service type

The Dales Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. [Care home name] is a care home [with/without] nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The registered manager was also the provider; they are legally responsible for how the service is run and for the quality and safety of the care provided. The provider had delegated some day to day responsibilities of the home to a home manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority Quality Improvement Team, who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the home early in the morning to speak with and observe both overnight and daytime staff members. We spoke with five people about their experience of the care provided. We also spoke with ten members of staff including the provider, home manager, care staff and administration staff. We spoke with two family members of people living in the home.

We reviewed a range of records. This included five people’s care records and a selection of people’s medication records. We looked at recruitment records for two staff employed since the last inspection.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 22 March 2022

The Dales Care Home provides accommodation for up to 31 people who require personal care in one adapted building. At the time of the inspection 28 people lived in the home. Some people at the home were living with dementia.

People’s experience of using this service and what we found

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. Staff promoted people making choices for themselves. People and their relatives told us they liked the home.

Care planning was person centred and focused on outcomes for people. People’s care plans now identified what was important to them, along with their needs and any risks in their care. This meant that staff had the up to date information they needed to provide safe and appropriate care that met people’s needs and preferences.

The provider had changed the systems in the home in relation to how they assessed, recorded and mitigated risks in people’s accommodation, care and support. These systems were effective in ensuring that staff had the most important and relevant information at hand, to enable them to be effective in supporting people to be safe.

Improvements had been made regarding the governance of the service. However, some of the governance systems had not been consistently maintained or had not always been effectively implemented. In relation to some areas of the providers oversight and governance, the service remained in breach of regulation.

The provider had made significant improvements in other areas of oversight of the service, which had led to improvements in the quality and safety of the service being provided. For example, the safety and effectiveness of people’s care and their care plans were checked upon and audited.

The standard of people’s accommodation and the furnishings and equipment people used had all improved. Areas of the home had been refurbished and the home’s environment was pleasant and clean. There was ongoing maintenance and a series of safety checks taking place at the home. This helped ensure the home’s environment was safe.

The home manager and staff at The Dales worked effectively in partnership with others and were engaging with local systems to support people’s needs. Family members told us that they had good communication with the home manager and staff at The Dales. Staff told us that they felt supported and listened to by the provider and home manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 14 July 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations in relation to; Safeguarding service users from abuse and improper treatment (Regulation 13), Safe care and treatment (Regulation 12) and, Fit and proper persons employed (regulation 19). Improvements had been made in relation to Good governance (regulation 17). However, the provider remains in breach of this regulation.

This service has been in Special Measures since 14 July 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We previously carried out an unannounced inspection of this service on 10 and 16 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met the legal requirements. This report only covers our findings in relation to the Key Questions, “Is the service safe?” and “Is the service well-led?” which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Dales Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.