About the service:

The service is a care home for up to 25 people some of whom live with dementia and/or a physical disability. 23 people lived in the service when we inspected.

Rating at last inspection:

Good (published 21 October 2016).

Why we inspected:

This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People told us they felt safe and happy living at Danmor Lodge. Relatives said they felt confident that their family members were well looked after. The staff demonstrated a good understanding of how to meet people’s individual needs and wishes and to raise concerns if they had concerns about a person’s health and well-being. People’s desired outcomes were known, and staff worked with people, their relatives and relevant health professional to help achieve these. People were encouraged and supported to maintain their independence and live their lives the way they wanted to.

People were supported to maintain contact with those important to them including friends, family and other people living at the home. Staff understood the importance of these contacts for people’s health. Staff and people were observed enjoying warm and mutually beneficial interactions. Staff had got to know people well and recognised and supported the things that made them individuals. A varied and inclusive activities programme helped people to enjoy their time at the home, stay active and develop new skills and interests.

The management of the home were well respected and promoted an open and transparent approach. People and relatives felt they were approachable and good listeners. Staff had a good understanding of their roles and responsibilities and were supported to reflect on their practice and pursue learning opportunities. Staff felt very supported and said their good work was recognised and rewarded. The staff team worked well together demonstrating team cohesion and flexibility.

Quality and safety checks helped ensure people, staff and visitors were safe and protected from harm. This also ensured that practice standards were maintained and improved. Audits helped identify areas for improvement and this learning was shared with staff. A culture of learning and improvement had been embedded by the management and was used to help identify ways to continually improve the experience for people living at the home.

A full description of our findings can be found in the sections below.

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

The inspection took place on 22 and 26 September 2016.

Danmor Lodge is registered to provide accommodation and personal care for up to 25 people in a residential area of Weymouth. At the time of our inspection there were 23 people living in the home and one person staying for a short break.

There was 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.

People felt safe and well cared for. They were protected from harm because staff understood how to reduce the risks people faced. They also knew how to identify and respond to abuse and said they would be confident to do so.

People had support and care when they needed it from staff who had been safely recruited and understood their needs. Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills.

People told us they saw health care professionals when necessary. Records and feedback from a healthcare professional reflected that staff responded appropriately to both ongoing healthcare needs and health emergencies. People received their medicines as they were prescribed.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their lives. Care plans and practice reflected the framework of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards had been applied for when people needed to live in the home to be cared for safely but did not have the mental capacity to consent to this.

People were engaged with activities that reflected their preferences, including individual and group activities both in Danmor Lodge and the local area. Activities were planned and delivered by people and activities staff.

Everyone described the food as good and there were systems in place to ensure people had enough to eat and drink. When people needed particular diets or support to eat and drink safely this was in place.

Quality assurance had led to improvements being made and people, relatives and staff were invited to contribute their views to this process. Staff, relatives and people spoke positively about the management and staff team as a whole.

People were positive about the care and kindness they received from the staff of Danmor Lodge. Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection.

People’s care needs and risks were assessed and care was delivered to meet their needs. One person told us, “I’m very, very happy here. The staff are so kind and do everything I need here.” Another person said, “The staff here are nice and friendly. They look after me exactly as I love.”

The home was clean and there were procedures to prevent and control the risk of healthcare associated infections.

The provider had effective systems to monitor pre-employment checks and recruitment procedures for staff.

The home had suitable systems to monitor the quality of service provided.

We spoke with six people who spoke positively about the home and the level of care they received. One person told us the staff were “Very good” and another said “They (the staff) get everything done for me.”

People’s care needs and risks were assessed, and care was delivered to meet their needs. People were protected from harm as there were appropriate safeguarding procedures.

Staff were supported by the provider through appropriate training, and the home had some suitable systems to monitor the quality of service provided. However, the absence of the regular auditing of care plan documentation and infection control measures had not ensured that certain documentation had been accurately completed.

We visited the home unannounced on Wednesday 21 March 2012. We had brought forward a scheduled review because of concerns raised during a safeguarding investigation. There were concerns about how people were being supported in their mobility and how they were supported to maintain their health.

When we arrived people were enjoying breakfast. Some people were enjoying the sunshine and others were being helped with their personal care. Staff were polite when speaking to people, considerate of their wishes and able to take time to chat with people.

One person with communication difficulties was supported by knowledgeable staff who understood the person’s needs. However information about their communication needs was not clearly recorded in their care plan.

We found that information was not clearly recorded about people's needs in their care plans. There was not an accurate picture of the care they received.

Staff were heard speaking patiently to people and were gentle when assistance was provided with physical needs.

People who lacked capacity had not been supported by an independent person to ensure decisions had been made in their best interest.

People told us that there were sufficient staff in place and that staff were very caring and responsive.

People told us that staff were kind. We were told that staff listen and people feel confident when they were being supported with their personal care.

People living in the home told us that they were positive about the care and support they received. People said their personal care needs were met and that they were treated with dignity and respect by the staff team. They said that staff responded promptly to requests for assistance and that they felt confident about raising concerns, or making criticisms, either to the care staff or to the management of the service.

People said they thought the home was kept very clean and their individual rooms were well maintained and decorated.