Daneside Court Nursing Home

Daneside Court is a residential care home providing personal and nursing care to 47 people aged 65 and over at the time of the inspection. The service can support up to 64 people. The care home accommodates people in purpose-built premises over two floors.

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

The nutritional needs of people were now better recorded and dining experiences for people had improved through regular checks by the registered manager. People were satisfied with the food provided but when issues were raised; these were dealt with promptly.

Systems used to monitor the quality of care provided were more effective with actions being identified and addressed in a timely manner. Staff considered that the registered manager was supportive and approachable. People told us that they knew who the registered manager was and they had regular contact with them. Relatives told us that the service was well-run and transparent.

People told us they felt safe living at Daneside Court. For those who could not express a view, observations found people were relaxed and comfortable with the staff team at all times. The recruitment of permanent registered nurses had been achieved and there were sufficient suitably recruited and trained staff available to respond to people’s needs. Robust measured were in place to mitigate the risk of people being infected by COVID-19 and relatives commented that despite their concerns about the health of their relations during the pandemic; the service had kept them safe.

People and relatives told us that the staff team were knowledgeable about their needs and sought to prevent adverse health conditions developing further through prompt contact with other medical professionals. The design of the building assisted people to mobilise independently and signage assisted with their orientation.

Care plans were person-centred and included the health and social needs of each person. People and relatives told us that they knew how to make a complaint and any received were responded to promptly. The wishes of people reaching the end of their lives and relatives were recorded and respected.

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 (and update)

The last rating for this service was requires improvement (published 14 January 2020) and there was a breach of a regulation relating to good governance and nutrition. 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 this regulation.

Why we inspected

This was a planned inspection based on the previous rating.

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 reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Require Improvement to Good. This is based on the findings at this inspection.

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

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.

Daneside Court Nursing Home is a care home providing personal and nursing care to adults aged 18 and over at the time of the inspection. The service can support up to people.

The care home accommodates people over two floors of a purpose built adapted building. People on the upper floor are supported by a Nurse.

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

There were governance systems in place to monitor the quality and effectiveness of the service. However, this did not highlight or address some of the concerns identified at this inspection.

People's hydration and nutritional needs were not always monitored or managed well. The dining experience for some people required improving.

Records used to demonstrate what care had been delivered throughout the course of the day and night were not always completed. Therefore, we could not be assured that people received the right care and the right time.

People said, and we observed, that there could be a delay in staff responding. We were also told there was sometimes lack of continuity in nursing care due to agency staffing being used the majority of the time. The provider told us they were trying to recruiting into these posts, but it was continuing to be problematic. We made a recommendation that the provider further review the number and deployment of staff throughout the home.

People's dignity was not always fully maintained. We observed people's bedroom doors were not always closed when staff were supporting people and the way in which some staff communicated with each other did not always afford the confidentiality or respect of people at the service.

Processes were in place to ensure the safe management of medicines. We spoke with the provider about ensuring the use of prescribed thickeners were appropriately recorded.

People's care plans were complete although not all were personalised or contained information on a person’s background. Staff, however, knew people and how they wished to be supported.

Risks to people had been identified and steps taken to mitigate any further occurrence. Lessons had been learnt from adverse incidents and reflective reviews undertaken with staff.

People and relatives told us that staff were kind and caring. They told us that they had not had to raise any concerns about their care but that there was a complaints system in place should they need to do so.

Staff knew how to safeguard people from abuse. They were recruited using systems which reduced the risk of unsuitable candidates being employed. Staff were supported through induction, training and supervision to ensure they had the skills and knowledge required.

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 sought consent from people when assisting them and had an understanding of the Mental Capacity Act.

A staff member was appointed to look at the physical and emotional wellbeing of people at the service A range of activities had been made available to people which were appreciated and enjoyed The service worked with other professionals to meet people's needs in a holistic way.

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 ).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to maintaining adequate nutrition, record keeping and good governance at this inspection.

Follow up

We will request an action plan for 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.

On the day of this inspection there were 55 people living at Daneside Court.

At the last inspection on 5 January 2015 the service was rated Good. At this inspection we found the service remained Good.

People and family members told us the staff were kind, caring and very helpful. They said the service and care was excellent. Comments included “I am very happy here”, “The staff are very good” and “The staff are very nice.” People told us that the food was very good. Relatives confirmed that people were safe with the staff and within Daneside Court .

People and family members told us that they had no concerns or complaints about the service. They were aware of and had access to the registered provider’s complaints policy and they said they would speak to staff if they had any concerns.

Care plans were well documented and held good information about the individual person. Risk assessments were in place as needed and were individually tailored to each person’s needs. All documentation was up to date. Medication was administered safely.

People were supported by staff who were knowledgeable about them and who had undertaken sufficient training to meet people’s needs. Staff recruitment was robust and prospective staff undertook appropriate checks prior to starting work at the service. Staff had good supervision and were encouraged to attend meetings.

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 were aware of the safeguarding policies and procedures and had received training in safeguarding adults.

The environment was clean and well maintained and the décor was of a good standard.

The registered manager used a range of methods to assess, monitor and improve the quality and safety of the service. These included regular audits across the service and meetings with people, family members and staff to seek their views about the quality of care being provided. A wide range of compliments had been received regarding the service.

We spoke to thirteen people who used the service. They said they were getting the care and support they needed. Some comments made were: - 'The staff are fantastic. They will do anything for you.' 'The staff are great, they look after you very well.' 'I'm very happy here.'

We spoke to seven relatives who were happy with the care and support provided. They described the staff as supportive and caring. Some comments made were: - 'It's a smashing place.' 'The staff look after my relative very well.'

During our visit we observed that staff were respectful, attentive and had a caring attitude towards the people who used the service. When people asked for support they received a good response.

We found that people had been assessed before they began to use the service and they had care plans that identified their needs. People's nutritional needs were well met.

There were good systems in place to promote infection control.

The staff were provided with the support they needed to enable them to meet the needs of the people who used the service.

There were good systems in place to monitor the quality of the service which meant that any shortfalls could be identified and improvements made when necessary.

However, we found that some of the concerns identified at out previous visit remained to be addressed

At this visit we identified that there had been improvements to staffing levels, practices around obtaining consent and care planning records. However, some further improvements were needed to the management of medication.

We spoke to five people who used the service. They said they were happy with the care and support they received from staff. They said that staff were attentive and provided support when it was needed. One person said they would like a change to be made to their bedtime routines which was brought to the attention of the temporary manager. Some comments made were:-

'We are well looked after. The staff are attentive and they come when they are needed.'

'I am happy enough. The staff are very good.'

We spoke to seven visitors who were relatives or friends. All described the care and support provided by staff positively. They said that staff were helpful, caring and respectful.