Dawson Lodge

We assessed five quality statements within the safe key question. There was a positive culture where people and staff were encouraged and supported to raise concerns. Incidents and complaints were investigated, and lessons learned to improve safety and people’s experience in future. Staff were recruited safely. There were enough staff to make sure people received consistently safe care that met their needs. Checks were in place to monitor the safety and upkeep of the premises and equipment. Some checks had not been completed at the intended frequency and the review of general risk assessments of the service was overdue. The acting home manager was working to address these shortfalls. Improvements had been made in the management of people’s medicines following external pharmacy audits and people told us they were satisfied with the management of their medicines. We identified shortfalls in the recording and monitoring of topical medicines (creams applied to the skin) and some liquid and cream medicines were not labelled when opened. The acting home manager took prompt action to address this.

However, we found some risks to people required a more detailed assessment to ensure risk management actions were fully identified and monitored. Staff we spoke with had good knowledge about people’s risk areas and how to manage them, however some records required review to ensure they were fully completed and consistent.

We identified a gap the availability of safeguarding training arranged by the provider. Although safeguarding was discussed with staff at interview, on induction and in meetings, some staff had not completed formal training in this area. In other areas, staff had received training and support to enable them to deliver good quality care and to develop their practice.

We assessed two quality statements within the effective key question. People’s needs were assessed prior to admission to the home and regularly reviewed. Needs assessments were holistic and person-centred. Staff we spoke with showed good knowledge of people’s needs and how to meet them, considering their likes/dislikes and preferences. People were supported with their healthcare needs. The systems in place supported prompt access to healthcare support and these included staff observations of indicators to deteriorating health. There were daily GP calls and daily and weekly meetings to share information about people’s health needs and progress. People had ready access to food and fluids including snacks. People and relatives spoke positively about the quality of food available. People’s dietary preferences and needs were catered for, and people were involved in the development of the menu.

We assessed two quality statements within the caring key question. People were involved in their care and chose how they wished to spend their time. Staff involved people in day-to-day decisions and supported them to be as independent as they were able. We saw people involved in a range of activities and enjoying the home’s garden. People were free to receive visits from family and friends. Staff had been through a challenging period but spoke positively about the direction of the service under the acting home manager. There had been a high turnover of staff. Staff feedback indicated there were areas of division within the team, including along the lines of ethnicity and length of service. The acting home manager and representatives of the provider were actively working to address this and bring the team together. Staff had opportunities to provide feedback and told us they felt comfortable raising concerns. They told us they felt valued and there were opportunities to develop in their careers. However, the process for obtaining consent to care and treatment by the relevant person was not always completed in line with the Mental Capacity Act. Following our inspection the acting home manager provided evidence they had reviewed this process and would be making changes.

We assessed one quality statement within the well-led key question. At the last inspection we identified the provider's quality monitoring had failed to identify concerns within the service. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the systems in place were providing oversight and delivering improvement. However, more time was needed to establish the acting leadership team and ensure systems were comprehensive and embedded into practice.