You are here

The Old Downs Dementia Residential Care Home Good

Inspection Summary

Overall summary & rating


Updated 16 September 2017

This inspection took place on 08 August 2017 and was unannounced.

The Old Downs Residential Care Home provides accommodation and support for up to 41 people living with dementia. It is set within its own grounds in the village of Hartley, close to Dartford, Kent. At the time of our visit, there were 35 people who lived in the service.

There was a new registered manager at the service. The new registered manager started in May 2017. 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 our previous inspection on 08 June 2016, we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. People's medicines were not always managed safely. Appropriate procedures were not followed in managing covert medicines and medicine risk assessments were not carried out. Malnutrition Universal Screening Tool (MUST) records were not always completed to identify adults who are malnourished, at risk of malnutrition (under nutrition) or obese. We asked the provider to submit an action plan by 07 September 2016. However, due to the registered manager leaving her position, we did not receive an action plan.

At this inspection, we found that the provider had met the breach of the regulation.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Staff knew each person well and had a good knowledge of the needs of people who lived at the service. Malnutrition Universal Screening Tool (MUST) records for five people we looked at were fully completed.

There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken.

The registered manager had systems in place to manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies. All of the people who were able to converse with us said that they felt safe in the service; and said that if they had any concerns they were confident these would be quickly addressed by the registered manager. Relatives felt their people were safe in the service.

The service had risk assessments in place to identify risks that may be involved when meeting people’s needs. The risk assessments showed ways that these risks could be reduced. Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely.

There were sufficient numbers of qualified, skilled and experienced staff to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe recruitment procedures.

Training records showed that all staff had completed training in a range of areas that reflected their job role, such as essential training they needed to ensure they understood how to provide effective care, and support for people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and the service complied with these requirements.

The food menus offered variety and choice. They provided people with a nutritious and well-balanced diet. The cook prepared meals to meet people’s specialist dietary needs. Both people and relatives told us they were happy with the food in the service.

People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended immediately to show any changes, and care plans were routinely reviewed every month t

Inspection areas



Updated 16 September 2017

The service was safe.

There were appropriate safeguarding adults procedures in place and staff had a clear understanding of these. Risks to people�s safety and welfare were assessed and managed effectively.

There were enough staff employed to ensure people received the care they needed and in a safe way.

There were effective recruitment procedures and practices in place and being followed.

Medicines were safely stored and administered to people.



Updated 16 September 2017

The service was effective.

Staff had received regular supervision from their line manager to ensure they had the support to meet people�s needs.

People�s rights were protected under the Mental Capacity Act 2005 (MCA) and best interest decision made under the Deprivation of Liberty Safeguards (DoLS).

People were supported effectively with their health care needs.

People were provided with a choice of nutritious food.



Updated 16 September 2017

The service was caring.

The registered manager and staff demonstrated caring, kind and compassionate attitudes towards people.

People�s privacy was valued and staff ensured their dignity.

People and relatives were included in making decisions about their care. The staff in the service were knowledgeable about the support people required and about how they wanted their care to be provided.



Updated 16 September 2017

The service was responsive.

People�s needs were fully assessed with them before they moved to the service to make sure that the staff could meet their needs.

The management team responded to people�s needs quickly and appropriately whenever there were changes in people�s need.

The provider had a complaints procedure and people told us they felt able to complain if they needed to.



Updated 16 September 2017

The service was well led.

The service had an open and approachable management team. Staff were supported to work in a transparent and supportive culture.

The provider had a clear set of vision and values, which were used in practice when caring for people.

There was a robust staffing structure in the service. Both management and staff understood their roles and responsibilities.

There were effective systems in place to monitor and improve the quality of the service provided.