Donnington House Care Home

Updated 20 October 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 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

The inspection was undertaken by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Donnington House 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. Donnington House Care Home is a care home with nursing care. The Care Quality Commission (CQC)regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with CQC to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

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 and professionals 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 information gathered as part of our monitoring activity that took place on the 20 July 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and six relatives about their experience of the care provided. We spoke to the registered manager and seven members of staff including registered nurses, care staff, ancillary staff and the chef.

We reviewed a range of records. This included seven people’s care records and medicine records. A variety of records relating to the management of the service, policies and procedures were reviewed.

Updated 20 October 2022

About the service

Donnington House Care Home is a care home providing personal and nursing care to up to 28 people in one adapted building. The service provides support to people with health care needs, Parkinson’s disease and frailty of age. At the time of our inspection there were 19 people using the service.

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

The provider did not have effective oversight or scrutiny of the service. Aspects of leadership and governance were not effective in identifying some of the concerns found. The service worked with other agencies. People views were sought about the service they received.

People told us they felt safe and systems and processes protected people from avoidable harm. People received their medicine safely. Risks to people were assessed and mitigated. Infection prevention and control processes protected people form the risk of infection.

People’s nutritional needs were met, and people were complementary about the meals. Staff felt supported and had access to training. People told us the staff were kind and compassionate. We observed positive interactions between people and staff.

People received compassionate and person centred support. There were enough staff to meet people’s needs. People told us staff responded promptly to their care needs and when they required support. Registered nurses ensured people’s nursing needs were met. People received compassionate and dignified end of life care in line with their needs and wishes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 1 June 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We received concerns in relation to risk management, deprivation of liberty under the terms of the Mental Capacity Act 2005, responding to complaints and the management and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only. 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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

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 breaches in relation to the management of the service at this inspection.

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.