Downers Court

Updated 31 July 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 19 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small care home. The registered manager may have been supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by one inspector.

Before the inspection we reviewed the information about the service the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service including previous inspection reports. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. We also reviewed information that had been given to us by whistle blowers. We used all this information to plan our inspection.

Some people were unable to verbally tell us about their experiences, so we observed care and support in communal areas. We observed staff interactions with people. We spoke with seven staff, which included support workers, the deputy manager, the registered manager and the facilitation director. We also telephoned two relatives to gain their feedback about the service.

We requested information by email from local authority care managers and commissioners who were health and social care professionals involved in the service. We received feedback from an independent consultant.

We looked at the provider’s records. These included two people’s care records, which included care plans, health records, risk assessments, daily care records and medicines records. We looked at two staff files, a sample of audits, satisfaction surveys, staff rotas, and policies and procedures.

We asked the management team to send additional information after the inspection visit, including staff training records, policies and medicines records. The information we requested was sent to us in a timely manner.

Updated 31 July 2018

The inspection took place on 19 April 2018. The inspection was announced.

Downers Court 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.

Downers Court accommodates three people in two single storey bungalows. All the people that lived at the service were men. People were not able to communicate their feedback and experiences verbally of living at the service.

The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service had 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.

Risks were appropriately assessed and mitigated to ensure people were safe. Medicines had not always been managed safely. Records evidenced that people had received their medicines as prescribed. Stock balances did not always tally with medicines records. Staff had not always followed the provider’s policy when booking in new medicines. The registered manager took immediate action to review the medicines practice, this included a thorough audit of stock, changes to medicines disposal and increased auditing.

Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. Having identified shortfalls during the inspection the registered manager immediately reviewed the quality checking processes and put in place new and revised systems to ensure that people were safe.

People were happy with their care and support. They indicated this through smiling, high fives and through their interaction with the staff supporting them. Staff had built up good relationships with people. Relatives confirmed that people were happy living at the service.

The service provided outstanding care and support to people enabling them to live as fulfilled and meaningful lives as possible.

Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the service was calm and relaxed. Staff treated people with dignity and respect. People’s privacy was respected. The service was small and homely.

People were supported to maintain their relationships with people who mattered to them. Relatives told us they were able to visit at any time. Relatives shared examples of how the service had positively impacted on their lives.

There were enough staff deployed to meet people’s needs. The provider had not always operated safe and robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. The registered manager took immediate action to address this during the inspection which ensured the service had a full employment history for each staff member.

Staff knew what they should do to identify and raise safeguarding concerns. The registered manager knew their responsibilities in relation to keeping people safe from harm.

People were encouraged to make their own choices about everyday matters. People’s decisions and choices were respected. This included people’s preferences for waking. Staff ensured that they didn’t make too much noise in the service when people were asleep.

People's care plans clearly detailed their care and support needs. People and their relatives were fully involved with the care planning process. The service had developed care plans, fact sheets and behaviour support plans to help staff know and understand how to work with each person and to understand how people’s diagnosed health needs impacted on their mental health and their behaviour.

People were encouraged and supported to engage with activities that met their needs. People accessed their local community with staff support.

People had choices of food at each meal time. People were supported and encouraged to have a varied and healthy diet which met their health needs.

People were supported and helped to maintain their health and to access health services when they needed them. Relatives were kept well informed about their family member’s health needs.

People and their relatives were given information about how to complain. Complaints had been handled effectively.

Staff were positive about the support they received from the management team. They felt they could raise concerns and they would be listened to.