Downlands

Updated 4 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 May 2018 and was unannounced. The inspection team consisted of one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

On this occasion we did not ask the provider to submit a Provider Information Return (PIR) before the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at information we held about the service. This included any complaints we had received and any notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted the local authority for their feedback before the inspection and received a copy of a health and safety review dated 23 February 2018.

During our inspection we spoke with nine people, three relatives and one visitor. We spoke with six members of staff, and the registered manager. We observed staff interactions with people. We reviewed a range of records about people’s care and how the service was managed. These included the care records for four people, medicine administration record (MAR) sheets, three staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.

The service was last inspected on the 11 April 2017 and was awarded the overall rating of Requires Improvement.

Updated 4 September 2018

The inspection took place on 8 May 2018 and was unannounced. Downlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home accommodates up to 23 people in one adapted building. The provider is registered to support older people and people with disabilities. The service offers long term or respite care. At the time of the inspection there were 16 people living at the home and nobody was receiving short term respite care.

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. At the time of the inspection the manager at Downlands had applied to become the registered manager. Shortly after the inspection the application process was completed and they were confirmed as the registered manager. They were present throughout the inspection.

When we completed our previous inspection on 11 April 2017 we found concerns relating to safe care and treatment. This was because risks to people were not always identified, assessed and managed effectively. After the inspection the provider sent us an action plan describing what they had done to ensure compliance with the legal requirements. At this inspection, on 8 May 2018, we found that the provider had followed their action plan, risks were being managed safely and the breach of regulations had been addressed.

People told us they felt safe living at Downlands. One person said, “Help is there when we need it. I never feel worried.” There were enough staff on duty to care for people safely. There were safe recruitment procedures in place and staff received an induction when they started working at the home. People were receiving the medicines they needed and staff demonstrated an understanding of their responsibilities to safeguard people. The home was clean and there were effective systems in place to prevent and control infection. Incidents and accidents were recorded, together with details of what actions had been taken, to prevent a recurrence, where possible. Learning from incidents was used to make improvements at the home.

Staff spoke positively about the training and support they had received. People and their relatives told us they had confidence in the skills of the staff. One relative said, “I am very happy with the staff, they know what they are doing and I feel my relation is in good hands.” Staff supported people to have access to health care services. They reported effective arrangements for working in partnership and advice from health care professionals was included within people’s care plans. People’s diverse needs had been assessed holistically and staff ensured that there was proper consideration of consent before providing care and support to people. People were supported to have the maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were happy with the food and said they had a choice of what to eat and drink.

People were treated with kindness and respect. One person told us, ”I don’t feel rushed, the staff are very respectful and always kind.” Staff supported people to be involved in planning their care. People were encouraged to be as independent as possible and their dignity was protected. One person said, “All the staff are great.”

Staff knew people well and provided care in a personalised way. People’s care plans were reviewed regularly and updated when things changed. People and their relatives knew how to complain and said they were confident that any concerns would be addressed. People were supported to make plans for the end of life.

People, their relatives and staff spoke highly of the management of the home and described the registered manager as, “approachable” and “efficient.” There were effective systems in place to monitor quality and drive improvements at the home. We noted that improvements made following previous inspections had been sustained and were embedded within staff practice.

There was clear leadership and staff understood their roles and responsibilities. Staff described positive communication both within the staff team and with other agencies. Staff meetings were held and staff confirmed their views on developments at the home were welcomed.

The overall rating for the home had improved to Good.