Archived: Downs Cottage Care Home (with Nursing)

Updated 8 September 2016

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 focussed inspection took place on 08 August 2016 and was unannounced. We had planned to carry out a comprehensive inspection, however shortly after the inspection began the provider announced the home would be closing in four weeks. We decided to focus on the Safe domain, to ensure people would be safe during the closure process.

The inspection team consisted of three inspectors.

Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

We did not ask the provider to complete a Provider Information Return (PIR) on this occasion, as we were responding to concerns that had been raised about the home. The PIR 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 spoke with two people who lived at the home, one relative and four staff which included the registered manager. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed how staff cared for people, and worked together. We also reviewed care and other records within the home. These included six care plans and associated records, and three medicine administration records.

At our previous inspection in April 2016 we had identified the home had made improvements to meet the regulations, however our findings on this inspection showed these had not been maintained.

Updated 8 September 2016

Downs Cottage Care Home provides nursing care for up to 23 older people including people who live with the experience of dementia and other mental health conditions. At the time of our inspection 13 people were living at the home. All required support with personal care and mobility.

There was 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.

The inspection took place on 8 August 2016, in response to concerns we had received, and was unannounced. The inspection was planned to be a ‘Comprehensive’ inspection to cover all five key questions about is the service Safe, Effective, Caring, Responsive and Well Led.

At the beginning of our inspection the provider announced that the home would close in four weeks. Due to this we changed to a ‘Focussed’ inspection to check that people would be kept Safe during the home closure. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Downs Cottage Care Home on our website at www.cqc.org.uk.

People were not protected from the potential risk of harm.

People at risk of choking had been given inappropriate food that increased the likelihood of a choking incident. People who should have been on a pureed diet to aid swallowing had been given chopped up burgers, sausages, pasta back, and sandwiches. The registered manager took immediate action to ensure this did not happen again.

There were not enough staff to meet the individual needs of people. The numbers of staff deployed left people at risk of falls unsupported. Arrangements for staff to call on other staff for help in an emergency, such as if someone fell, were inadequate. Staff made reference to sounding the alarm bell to call for aid, but this could not be found on the day of our inspection.

The home had not been maintained to assure peoples safety. The landlords gas safety certificate expired in April 2016, so they could not be certain the gas appliances were safe at the home. Risks to people from the spread of infection had also not been managed in a timely way. A risk identified during a night shift was not dealt with by staff the next day, until we brought it to the provider’s attention. This increased the chance that the infection would spread around the home. The provider took action to alert the appropriate authorities, and have the situation dealt with the day after our inspection.

We identified one breach in the regulations. We met with the provider, and wrote them a formal letter to outline the actions we required them to take to ensure people where kept safe during the closure of the home.