The inspection took place on 5 December 2016 and was unannounced. The home was previously inspected in January 2016 when a breach of the legal requirement was identified. The provider sent us an action plan outlining how they would meet this breach. You can read the report from our last inspection, by selecting the 'all reports' link for ‘Dunniwood Lodge’ on our website at www.cqc.org.uk. Dunniwood Lodge is a care home which provides care and support for up to 44 older people. It is situated in Bessacarr, near Doncaster within easy reach of bus stops, shops and other amenities. At the time of our inspection there were 36 people using the service.
The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Throughout our inspection we observed staff interacting with people who used the service and found there were enough staff on duty to meet people’s needs. However, there were times throughout the day that staff were not deployed appropriately and could have been more organised. For example, we observed breakfast taking place and saw that some people who required assistance were not supported. We also observed people ringing the call system and it taking staff quite a while to respond to them.
We looked at records in relation to medicine management and found each person had a Medication Administration Record sheet in place. However, we found some gaps in recording medicines. Therefore this did not always evidence when people had been given their medicines. We spoke with the registered manager who had already commenced action to address this.
We saw risks associated with people’s care had been identified and risk assessments had been put in place to help reduce the risk from occurring.
We looked at three recruitment files and found the provider had a safe and effective system in place for employing new staff. The three files we looked at contained pre-employment checks and they were obtained prior to new staff commencing employment.
Staff were knowledgeable about protecting people from the risk of harm and knew what action to take if someone was at risk of abuse.
We looked at records in relation to training and saw that some training required updating to bring it in line with the providers policy. We spoke with the registered manager and were told that training was completed face to face by an outside training company. Staff felt supported by the registered manager.
People received a balanced diet based on their individual needs and choice. However, some people struggled to eat their food as they required more support. Drinks and snacks were provided at regular interval throughout the day.
Through our observations and from talking with staff we found the service to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). We spoke with the registered manager who knew when to apply for DoLS for people and evidenced that some applications had been made to the supervisory body. Some had been approved and some were awaiting the outcome.
We observed staff interacting with people and we found they were mostly kind and caring in their approach. However, some interactions were task focused and were not personalised to individual people. Staff ensured that people’s privacy and dignity were maintained.
We looked at care plans belonging to people and found they did not always give a clear picture of the support people required and did not always give enough detail. We spoke with the registered manager about this and were told that all care plans were in the process of being updated as audits of care planning had revealed similar issues.
We spoke with people and were told that activities took place. However, the activity co-ordinator was not available on the day of the inspection and there was not much activity for people to get involved in.
The service had a complaints procedure and people felt able to raise concerns with the registered manager.
We spoke with people who used the service, their relatives and staff and they felt the registered manager was approachable, friendly and would address any concerns without delay.
We saw that audits had been completed to ensure the service was providing appropriate care and support. We also saw that actions were addressed and resolved.
We saw evidence that people were involved in the service and were asked for their feedback. People were able to contribute to new projects and offer ideas and suggestions to improve the service.