10 January 2023
During a routine inspection
About the service
Durlston House is a residential care home providing personal care to 5 people at the time of the inspection. The service can support up to 5 people.
People’s experience of using this service and what we found
Right Support
The provider did not have enough suitably trained staff to provide the support people needed. Staff were not suitably trained to administer rescue medicine, prescribed for one person in the event of a prolonged seizure. The service did not have sufficient staff to provide support in line with the hours commissioned by the local authority. This restricted some of the activities that people could participate in.
Systems in place to manage risks to people were not always effective and records were not always up to date. Some records contained conflicting information about the support people needed to stay safe. Staff completed incident reports where necessary, however, these had not been reviewed by the management team in a timely way. This increased the risk that action would not be taken to learn lessons following incidents.
The provider had good infection prevention and control systems. Staff took appropriate action to prevent the transmission of infections. The home was clean and hygienic.
People were supported to plan and prepare their meals. Staff provided support and guidance on maintaining a balanced diet.
The service had been designed to meet people’s needs. Self contained accommodation had been built in the home to meet the needs of 1 person. Other people had been supported to personalise their bedroom to make them comfortable spaces.
Right Care
People were treated with kindness and appeared comfortable and relaxed in the presence of staff. We used the ‘Talking Mats’ communication system with 1 person, who told us they liked the staff. Relatives told us they thought people were well treated and were confident their relative was protected from abuse.
Staff demonstrated a good understanding of people’s needs. We observed staff interacting with people in a friendly and respectful way.
People were supported to access the health services they needed. Regular assessments were completed to ensure people had attended regular health appointments, such as dentists, annual health checks and specific health clinics.
Right culture
Staff did not always work within the principles of the Mental Capacity Act (MCA). We identified 2 examples where staff had restricted people. At other times we observed staff working within the principles of the MCA and records of support also demonstrated this.
Staff did not consistently use people’s enhanced communication systems.
The provider did not have effective systems to assess, monitor and improve the quality of the service being provided. The systems that were in place had identified improvements were needed, but actions to make these improvements had not been completed in a timely way.
People were supported to maintain key relationships and take part in a range of activities, although some activities were limited due to staffing levels. Staff supported people and their representatives to made decisions about their care. These views were recorded in their support plans.
Staff worked in ways that respected people’s privacy and dignity.
The service had newly appointed manager and area manager. They reported they were aware of the shortfalls and were in the process of addressing them. The manager said their focus was on recruitment, to ensure they had sufficient staff to provide safe and positive support for people. Relatives told us communication with the management team had improved significantly since the appointment of the present manager. They said the manager had worked with them to resolve any concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 1 December 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches of regulations in relation to safe care and treatment, staffing and good governance 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.