Background to this inspection
Updated
5 January 2019
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 the 15 and 21 November 2018. We gave the provider 48 hours' notice of our inspection because we needed to be sure staff would be available to support the inspection process. The inspection was carried out by one inspector.
Before the inspection, we reviewed information we held about the service such as notifications. A notification is information about important events which the provider is required to send us by law. We contacted the local authority and Healthwatch before the inspection to obtain their views about the service and care provided. The inspection was brought forward due to changes in the registered provider which had led to the service not being inspected. Therefore, the provider was not asked to complete a Provider Information Return on this occasion. 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 took this into account when we inspected the service and made the judgements in this report.
During the inspection process, we spoke with six people who used the service, and two relatives. We spoke to six staff members that included the registered manager, care manager and four care staff. We also spoke with two visiting community nurses. The inspector visited four people with a staff member in their own accommodation to gain their experiences of the care provided and to review relevant documentation. We were able to observe the support provided and interactions between people and staff.
We reviewed four care records and risk assessments. We looked at three staff recruitment files, staff supervision and training records, the service user guide, staff meeting minutes, audits and quality assurance checks. We looked at medicines records, accidents and incidents reports and a range of policies and procedures.
Following the inspection visits we contacted three further health and social care professionals involved in caring for people who used the service. This included a commissioner of the service a specialist nurse and a social care professional.
Updated
5 January 2019
Downlands Court provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building.
The accommodation is rented or partially owned, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. The building is owned by Saxon Weald and has a restaurant on site that provides a midday meal to everyone living at Downlands Court under their service agreement. Communal areas are available on site where people can meet.
Not everyone living at Downlands Court receives the regulated activity. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection, there were 20 people receiving the regulated activity.
This was the first inspection of the service since their registration with the CQC in March 2018, following a change in provider. Staff and the care manager (branch manager) were based in an office within the ‘extra care’ housing.
This inspection took place on 15 and 21 of November 2018. It was an announced visit, which meant the service was given 48 hours’ notice, to ensure staff were available to facilitate the inspection.
The service had a registered manager who was also the registered manager of another service within the same organisation. 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. The registered manager was supported by a care manager who carried out day to day management of the service.
Feedback we received from people about staff and the service provided was very positive. However, the provider had not ensured suitable, accurate records were maintained in all areas. Some care plans were not complete and records relating to some medicines were not accurate. We did not identify that this had impacted on care, and the care manager took steps to address these areas following the inspection, however systems to ensure appropriate records in all areas were needed.
People were supported by staff they liked and who knew them well. Staff understood people’s needs and preferences. People were visited at times they wanted and staff stayed the correct amount of time to meet their individual needs. Packages of care were reviewed and adapted as necessary. Staff recognised when people’s needs changed and staff ensured health and social care professionals were involved to promote people’s health and well-being.
There were enough staff working with the right skills to respond to meet people’s assessed needs. Staff had a good understanding of the procedures to follow to safeguard people from the risk of abuse and to protect people’s individual rights. People’s choices were assessed and staff delivered care in a person-centred way that reflected people’s wishes.
People said their privacy and dignity were respected and they enjoyed positive relationships with staff. People were protected from the risk of poor nutrition and staff were aware of people's nutritional needs.
Staff received a rolling programme of essential training and new staff undertook a thorough induction programme. Staff were trained in the principles of the Mental Capacity Act 2005(MCA) and understood the importance of gaining consent from people. The management team knew the correct procedures to follow when people lacked capacity to make decisions.
The management were visible and accessible and were committed to improving and developing the service. People were asked for their view on the service and support they received and were aware of how to make a complaint. There was an open and positive culture at the service which had clear aims and objectives. Staff were supported and encouraged to contribute to the running of the service.