Durban House

This CQC inspection report for Durban House highlights areas where the service is working to improve, while also identifying ongoing concerns that need to be addressed. The report covers the safety, effectiveness, caring nature, responsiveness, and leadership of the home. While some positive changes have been implemented since the last inspection, the overall rating remains "Requires Improvement" due to several areas needing further attention. The inspection aimed to ensure that regulatory requirements were being met and to check progress on the provider's action plan.

On the question of safe care, the report notes that improvements are still needed in how risks to residents are assessed and managed, with ongoing concerns about the completeness and accuracy of risk assessments. Specific issues were identified regarding choking and falls risk management, as well as the maintenance of the environment and equipment. There were also gaps in record-keeping for fluid intake and weight monitoring, and a need to ensure fire safety plans are tested with night-time staffing. Furthermore, the report found that systems for safe recruitment and safeguarding residents from abuse were not sufficiently robust, with some required checks and referrals not being completed in a timely manner.

In terms of how effective the care is, the report acknowledges that improvements have been made to ensure care plans are more personalised and reflect best practice. Residents and relatives expressed confidence that needs were being met, with specific examples of positive recovery and excellent care being provided. The home is working to ensure residents have maximum choice and control, and staff understand their capacity. However, there's a need to further evidence best interest consultations and ensure decisions made on behalf of residents always follow proper processes. Improvements are also needed in medicine management, with a lack of detail in protocols for "when required" medicines.

Regarding the caring aspect of the service, residents and their families felt listened to and that their views were acted upon. Staff were observed to be respectful of residents' choices, for example, in their right to refuse medication. The report indicates that overall, residents appeared comfortable and well-cared for.

On responsiveness, the inspection found that while relatives felt their feedback was acted upon, this needed to be more clearly evidenced in relation to residents. There were instances where immediate needs were not always met due to staff being occupied with other tasks, particularly during mealtimes.

Finally, concerning the leadership and how well-led the service is, the report states that while there are regular meetings and a commitment to learning from incidents, governance arrangements need to be more robust. The leadership team has shown transparency and apologised when things have gone wrong, and works well with external health professionals. However, the continued breaches in fundamental standards indicate that systems for oversight and ensuring compliance require strengthening. The provider has been proactive in addressing some identified issues, such as recruitment of new staff and developing a sponsorship program.