Dundoran Nursing and Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. There was a system in place to record and monitor accidents and incidents. Accidents and incidents were reviewed on a regular basis by the management team. This enabled them to analyse trends and identify any lessons learnt. The manager held daily meetings with staff to ensure they had oversight of the needs of people. Staff told us they had up to date information about any changes in people’s need or lessons learnt following incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. A family member told us, “The move here was all organised. [Name] came by ambulance. All medication was here and personal items.” Detailed assessments of people’s needs were undertaken and care plans quickly developed to assist staff to support people safely. Staff told us they felt well informed when people moved into the home, or returned from other care settings, such as hospital. A staff member commented, “If a new person comes in, we are told about their likes/dislikes. I am kept very well informed.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Systems were in place to protect people from the risk of abuse. Staff received training and understood the actions they must take if they felt someone was being harmed or abused. Referrals had been made to the local authority safeguarding team when abuse had been suspected, and investigations had been completed. Family members told us they felt people were kept safe and the manager was responsive to any concerns they had. We were told, “I feel [Name] is safe and cared for” and “The new manager is much better. They are approachable and their door is always open.” Information explaining how people could raise concerns if they felt a person was being abused was clearly displayed in the reception area.

The provider worked with people to understand and manage risk. People’s needs were appropriately assessed. Risk assessments had been completed and detailed care plans had been developed to minimise any risk to people’s health and wellbeing. Staff provided care to meet people’s needs which was safe, supportive and enabled people to do the things that mattered to them. Throughout our assessment, we observed safe working practices, such as moving and handling of people being carried out. People also had the necessary equipment they needed to be supported safely. One family member of a person at risk of falls told us, “[Name] has sensor mats in their room as they can wander."

The provider detected and controlled potential risks in the care environment and made sure equipment, facilities and technology supported the delivery of safe care. Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this. Some areas of the home including hallways and lounge areas were tired in appearance and needed refurbishment. There was a scheme of refurbishment underway at the time of our assessment. New flooring had been laid, and the main lounge area was being fully redecorated. Further improvements to the décor throughout the home were planned.

The provider made sure staff were suitably qualified, skilled and experienced and received effective support, supervision and development. A staff member told us, “I have received all necessary training.” Staff were safely recruited. Appropriate checks had been made before applicants were offered employment. Most people told us staff responded promptly to requests for care and were present around the home to assist people who received care in bed. Comments included, “Staff always pop down. They don’t leave you on your own” and “I have got my buzzer. Staff come within 10 minutes; I am not left waiting ages.” We also observed staff responded quickly to the needs of people. However, this view was not shared by everyone. Some people told us they felt staffing levels needed to be increased at certain times of the day. One person commented, “We need more staff especially after dinner in the lounge when people’s needs can become more challenging. It gets far too difficult for the staff as there are just not enough of them.” A person raised some concerns about the care they received and staffing levels at a different time of the day. We shared this feedback with the management team and the manager told us they were planning to work this shift pattern to observe and, if needed, coach staff to improve practice.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean and well maintained. One person told us, “It’s always kept very clean and tidy. The domestic staff are amazing.” There was enough personal protective equipment (PPE) throughout the home for staff to use when needed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. One person told us, “I always receive my medication on time.” Records of administration were maintained and in line with best practice. This included when people were prescribed creams. Guidance was in place for all prescribed medicines administered on an 'as required' basis. This helped staff to understand why certain medicines were prescribed; and under what circumstances they should be offered to a person. Medicines were stored securely and only administered by staff who were suitably trained.