Background to this inspection
Updated
10 May 2017
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.
We last inspected the service on 10 November 2015. At that inspection we found the service was compliant with the fundamental standards we inspected. However, the service was rated “Requires improvement” in “Safe”.
This was a comprehensive inspection which took place on 22 and 23 March 2017. The inspection was announced. The provider was given 48 hours’ notice because the location supports people with a learning disability, some of whom are on the autistic spectrum. This was to allow the service to prepare people for our visit so as to minimise their anxiety. The inspection was carried out by one inspector.
Prior to our inspection we looked at and reviewed all the current information we held about the service. This included notifications that we received. Notifications are reports of events that the provider is required by law to inform us about. We also reviewed the last inspection report and contacted a representative of the local authority for their feedback.
During the inspection we spoke with both of the providers, the newly appointed manager, the assistant manager and three of the care staff. We spent time in the house observing interactions and spoke to three of the people supported about their experience in the service.
We examined a sample of five care plans and files relating to peoples care. We looked at a sample of other records to do with the operation of the service, including health and safety certification, recruitment records and medicines recording.
Updated
10 May 2017
This inspection took place on 22 and 23 March 2017 and was announced.
Downview Residential Care Home offers a service for up to seven people with learning and associated disabilities. Twenty four hour support is provided by a regular team of staff.
No registered manager was in place in the service. 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. A new manager had been appointed and started work two days prior to this inspection. She planned to apply for registration.
At the previous inspection in November 2015 the service was rated good overall, although some improvements were needed under “safe”. Recruitment procedures had not always been followed robustly and regular in house checks of fire equipment had not taken place between service visits.
At this inspection we found these matters had been addressed. The recruitment process was robust and prospective staff had been subject to the required checks of their suitability. Health and safety and fire safety checks and servicing had all been carried out as required.
At this inspection we found people were safe and well cared for. People felt staff treated them with kindness, respected their dignity and involved them in decisions about their care. People had been resident for a long time and staff knew them well. The service had a relaxed and calm atmosphere and interactions between people and staff were respectful.
People had detailed care plans which identified their individual wishes, needs and aspirations. They provided clear guidance to staff about how to support each person. However, it was not clear if care records had been recently reviewed and some documents were not dated or signed.
The service had experienced a period of unsettled management, without a registered manager since July 2016. Records and systems within the service required review and updating and the service required a more thorough system of management monitoring. The new manager had already begun taking steps to address these points as part of her action plan.
Staffing levels were sufficient to promote safe and effective care and enable people to access the community freely. People took part in a wide range of fulfilling activities, including voluntary work and they enjoyed busy lifestyles.
Staff received regular training updates, although supervision had not been provided regularly throughout the previous 12 months. The new manager had already put in place a schedule of supervision meetings for staff throughout the year.
People’s rights and freedom were protected and promoted. Their dietary and health needs were met effectively and staff involved people in these aspects of their care as much as possible. People’s spiritual and cultural needs were also met.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.