About the service:

Dovecote Lodge offers short stay accommodation and rehabilitation therapy for older people. It was providing personal care to 20 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

People were happy with the service they were receiving. They said staff were kind, caring and considerate and supported them as much as possible. We saw staff were responsive to needs and promoted people’s dignity at all times.

The service demonstrated effective partnership working with local services, especially as people were only in the service a short while. There were robust systems in place to manage people’s changing needs and the registered manager provided sound leadership along with their team. Care documentation was reviewed frequently to ensure it remained accurate.

Staff were knowledgeable and experienced in managing risk and were supported with regular supervision and training. Medicines were managed safely and the premises were clean.

People were supported with their nutrition and hydration needs. Activities were limited but we observed people happy to chat to each other, and staff interacted well.

Staff knew how to recognise and report potential abuse and any incidents were monitored closely. Quality assurance measures were appropriate and if issues were identified, action was taken swiftly.

More information is in the full report.

Rating at last inspection:

Requires Improvement (report published 1 February 2018)

Why we inspected:

This was a planned inspection based on the rating at the previous inspection. The service had previously been in breach of two regulations but at this inspection we found improvements had been made.

Follow up:

The service will continue to be monitored in line with our inspection programme, and if information of concern is raised, this will be investigated.

The inspection of Dovecote Lodge took place on 21 and 28 November 2017 and was unannounced. At the last inspection in December 2014 the service was rated as good overall.

Dovecote Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides a short stay care home facility, which offers accommodation and rehabilitative therapy for up to 28 older people. The service supports people who are waiting for a package of care to be organised or for adaptations to their home to enable them to return home to live independently, often following a stay in hospital.

Dovecote Lodge has two floors with bedrooms on both floors which are accessible by a lift. There were 18 people living in the home on the day we inspected.

There was a registered manager in post. 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 said they felt safe and we saw staff were aware of individual risks. Risk assessments for individual people were recorded appropriately.

Systems for managing medicines were understood by staff, although some areas of medicines management were in need of improvement, such as recording.

Staff induction, training, supervision and competency checks were in place to support staff in their roles.

People enjoyed the meals at Dovecote Lodge and they had regular opportunities for snacks and drinks, in line with their individual dietary needs.

Staff approach was caring, kind and respectful. Staff made the effort to get to know people, even though for some their stay was short.

Care documentation was focused on risk and people’s care needs, rather than highlighting the individual person in the process of their care.

People were given time to recuperate and convalesce. However, there were limited opportunities for people to engage in skills of daily living in preparation for leaving Dovecote Lodge.

People said they did not have enough to do and they wanted to be better informed about the next steps in their care.

There was clear leadership in the service and all staff understood their roles and responsibilities. The management team was visible and involved in people’s care and people told us the service was well run.

Quality assurance systems and processes were in place, a though these were not always thorough or detailed enough to fully monitor the quality of the service.

We identified two breaches in regulations relating to safe care and treatment and good governance. We have also made a recommendation the provider considers how people can be involved and how meaningful activity can be incorporated into the experiences of people whilst at Dovecote Lodge.

You can see what action we told the provider to take at the back of the full version of the report.

The inspection took place on 10 December 2014 and was unannounced.

There were no breaches of the legal requirements that we checked at the last inspection in July 2013.

The service provides short stay accommodation and rehabilitation therapy for up to 28 older people. The service supports people who are waiting for a package of care to be organised or adaptations made to their home to enable them to go back and live independently in their own home. Dovecote Lodge is situated in a residential area of Wakefield.

At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The service was warm, friendly and welcoming with a calm and relaxed atmosphere. People were content and settled and they were supported through good relationships with staff who understood their individual needs.

People were treated with respect and their dignity and rights were promoted. Staff showed positive regard for people’s abilities and they empowered them to maintain their independence and be involved in their care.

The registered manager had a sound understanding of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

Teamwork was strong and staff worked together with one another and with visiting professionals to support people’s health care needs. Handover information was shared well between shift changes to ensure people’s care was properly maintained.

Staff had sufficient opportunities for regular training and professional development to enhance their skills and knowledge of working with people in the service.

People’s care records provided detailed information for staff to be able to support their individual needs safely.

People were given good explanation about their medications and staff took time to make sure people were supported during medication rounds. However, we were concerned to note the medication trolley was left unattended and unlocked during medication rounds which compromised people’s safety.

People and their relatives praised the service and the staff, although they said there was little in the way of daytime activities and that sometimes they did not have enough to keep them occupied.

Systems to monitor and review the quality of the provision were in place and the registered manager maintained an overview of the service by being involved in people’s care.

You can see what action we told the provider to take at the back of the full version of the report.

We spoke with six people, two care staff, two relatives and the manager. We observed care and looked at records to show how people’s care was maintained. We saw that the home provided comfortable, well maintained areas for people to live. People told us they thought the home was clean. One person said: “It’s spotless in here”.

People we spoke with told us they were very happy with the care they received overall. They said the staff were very kind and helpful. One person told us: “They can’t do enough for you”. People told us they had enough to do, but some said they felt a bit bored at times. We saw people spent their time in activities of their choice.

Staff we spoke with were knowledgeable about people’s individual needs and respectful of their wishes and their rights. We saw there were enough staff on duty to meet the needs of the people. We saw people were always consulted and their views fully regarded about their care.

We saw written information was readily available to people and their relatives, should they need to raise a complaint. One person told us: “I’ve nowt to complain about”.

You can see our judgements on the front page of this report.

We spoke to six people who used the service. All the people we spoke with enjoyed staying at the home. They told us that the home was ‘very nice,’ and the ‘staff are very good.’ We saw that interaction between staff and the people who used the service was warm and courteous.

We looked at the care plans of five people who used the service. We saw that they were tailored to meet individual need. There were risk assessments in place to reduce the risk of harm to the individual.

The people who used the service told us that the food was ‘very good,’ and ‘you can eat what you want here.’ We saw that people were offered drinks and snacks through the day.

The service had been undergoing a significant change in the way it provides its service, from a permanent residential home to providing short term placements to people awaiting packages of care, including close liaison with the NHS Therapy . The staff were dealing with the changes in a positive way. One staff member told us ‘I enjoy my job.’ Another staff member told us that ‘they enjoyed seeing people go home happy.’

We saw that there was a corporate safeguarding and whistleblowing policy in place to support staff and protect the people who used the service. The staff we spoke with told us that they had received training in safeguarding.

We looked at the files of four staff members. We saw that they received regular supervision and regular training to up date their skills and knowledge.

We spoke with six people who live at the home and two relatives. The majority of people are in the home for a short stay recovering from being in hospital and awaiting a care plan for them to return home.

All the people spoken with were very positive about the staff and the support they

receive. Some of their comments included "“Staff have been wonderful they are lovely nothing is a problem for them."

"The food is gorgeous could not have gone to a better restaurant. They easily catered for my diabetes "

"The staff are always very respectful my sister was here recently ands she thought it was smashing"

" The staff are kind I had a difficult time in another place about the call bell but they told me to use it whenever I needed anything day or night."

People understood their care and the support they needed. They told us that they are encouraged to make their own decisions about their daily activities. No one had any concerns during their time at Dovecote Lodge but knew what to do if they did.

We spent a period of time sitting with a group of people in a lounge. We were able to observe people’s experiences of living in the home and their interactions with each other and the staff.We observed people receiving postive care which was focused on their indiviuial needs.