Dorset House

Updated 22 August 2019

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 Care Act 2014.

Inspection team

On 8 July 2019 the inspection team consisted of two inspectors, one specialist advisor [who was a registered nurse] 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. Two inspectors returned to conclude the inspection on 11 July 2019.

Service and service type

Dorset House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (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 CQC. 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.

Notice of inspection

The first day of the inspection visit was unannounced. We informed the registered manager in advance of when we would be returning for a second day to complete the inspection visit.

What we did before the inspection

Before the inspection visit, we looked at the information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority, clinical commissioning group and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

During the inspection, we spent time with people in the communal areas of the home and we saw how staff supported the people they cared for. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with six people who lived at the home and three relatives to find out their views of the quality of the care provided. We also spoke with the registered manager, operations manager, director of quality assurance, head housekeeper, administrator, second chef, activities co-ordinator, a nurse and four care staff.

We looked at a range of records. This included sampling four people's care records and multiple medication records. We also looked at records relating to the management of the home. These included systems for devising staff rotas, planning training, managing incidents, and the checks undertaken by the registered manager and the provider's management team on the quality of care provided.

After the inspection

We received clarification from the registered manager to validate evidence found. This included staff training planner and rotas and; infection control procedures and policies.

Updated 22 August 2019

About the service

Dorset House is a residential care home providing personal and nursing care for up to 42 older people within one large adapted building. At the time of our inspection, there were 35 people living at the home.

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

People were supported with their individual needs however care documentation was incomplete. This had the potential to result in people's needs not being responded to in a consistently personalised way. We made a recommendation about this.

People who lived at the home and their relatives were positive about the care and support provided by staff. The registered manager and their staff team worked in partnership with other health and social care professionals to provide responsive and continuous care to people.

People told us they felt safe at the home. Risks to people were managed without placing undue restrictions upon them. Staff were trained in recognising and understanding how to report potential abuse. Staffing arrangements were regularly reviewed by the registered manager to ensure these continually supported people's safety. Staff knew how to reduce the risks of infections.

Staff were recruited safely; they received regular support and training. New staff were provided with an induction which provided them with the relevant knowledge and skills for their roles. The registered manager reviewed staffing arrangements on a regular basis, so they could continually improve these when required to effectively meet people’s individual needs.

People were supported to receive their medicines and were happy with the arrangements in place for staff to assist them with their medicines. People we spoke with told us staff responded to their health needs. People were supported to eat and drink enough and had a choice as to where to eat their meals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff always respected people’s privacy and dignity. People were supported to engage in things for fun and interest. The registered manager reviewed the opportunities people were offered to ensure they continued to be of interest and benefit to people.

Some information was in accessible formats and the registered manager was aware of broadening this out to further support the individual needs of people who lived at the home. People's concerns and complaints were listened and responded to.

Staff felt supported by their colleagues and the registered manager and spoke positively about the care they provided. They felt able to share issues and ideas to make improvements for the benefit of people who lived at the home.

There were quality assurance systems and processes in place to monitor and improve the quality and safety of people’s care. These had worked effectively to drive through the improvements following the last inspection. The registered manager would use their quality monitoring systems to make further improvements to people’s care documentation.

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 (report published on January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.