Downs View Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider ensured people’s care and treatment were effective by assessing and regularly reviewing their health, wellbeing and communication needs in partnership with them. During the inspection, we saw assessments were clearly documented, with involvement from family members and professionals where appropriate. Care plans were routinely reviewed and updated through the provider’s “resident of the day” process. Staff told us information from assessments, along with any changes in need, were shared at a daily meeting. One relative said, “I’m the power of attorney for my relative, so it goes through me, and they chat it through with me.”

The provider planned and delivered people’s care and treatment in partnership with them, ensuring that what mattered to each individual was recognised and prioritised. Care and treatment were delivered in line with legislation and evidence‑based good practice.

People’s nutritional and hydration needs were clearly documented in care plans. Staff used the Malnutrition Universal Screening Tool (MUST) to assess and monitor the risk of malnutrition. Individuals who required fortified diets due to weight loss, or modified diets due to swallowing difficulties, were supported appropriately and in line with the International Dysphagia Diet Standardisation Initiative (IDDSI) framework.

Staff told us they monitored people’s nutritional intake to ensure they were eating and drinking adequately and meeting agreed targets. Any concerns about appetite were escalated promptly to the GP, and appropriate assessments were completed. People’s weights were monitored regularly to track progress.

The provider worked effectively across teams and services to support people. Information was shared appropriately between services, helping to ensure people only needed to tell their story once when moving between different settings.

Staff worked in partnership with each other and with healthcare professionals from local health teams. For example, community nurses visited daily to support people who required insulin, and specialist clinicians, such as care home liaison teams, also provided support. A healthcare professional told us that communication with the provider was effective.

The provider supported people to manage their health and wellbeing in ways that promoted independence, choice and control. Staff encouraged people to live healthier lives and, where possible, reduce their future need for care and support.

People told us they enjoyed the food, describing it as plentiful, fresh and consistently good quality. Comments included, “Food is lovely and lots of it all the time,” and “The chef is always engaging with people and checking they have enjoyed their food; it’s always so fresh.”

Staff demonstrated a good understanding of people’s nutritional needs, including requirements related to diabetes, fortified diets and appropriate diet consistency.

The provider monitored people’s care and treatment to drive continuous improvement. They ensured outcomes were positive, consistent and aligned with both clinical expectations and what people wanted to achieve. We found when a need or risk had been identified, staff monitored and recorded outcomes appropriately. For example, 1 person had been identified as being at risk of skin breakdown, and staff notes demonstrated regular and effective monitoring. This included documenting the person’s history, their current skin condition, their Waterlow score (a clinical tool used to assess a person’s risk of developing pressure ulcers by considering factors such as mobility, nutrition, continence and skin integrity), the preventative measures in place such, as the use of barrier cream, and the escalation process to follow if concerns arose.

People told us staff were always willing to help. Staff said they documented updates and shared relevant information with colleagues and families where appropriate.

The provider did not always ensure people were informed of their rights in relation to consent and these rights were not consistently respected when care and treatment were delivered. Care plans identified people’s levels of capacity where appropriate; however, Mental Capacity Act 2005 (MCA) assessments were not always completed in line with best practice. For example, assessments were not always documented as decision specific, and in some cases multiple decisions were recorded within a single assessment rather than being completed individually. This meant, people were not always fully protected by robust MCA processes, increasing the risk that decisions about their care and treatment were not consistently made in line with legal requirements.

The nominated individual acknowledged these shortfalls and confirmed there was a plan in place to review and update documentation to ensure it meets the requirements of the MCA. Staff told us they worked in line with MCA principles, including assuming people had capacity unless assessed otherwise and supporting people to make day to day choices to promote independence and autonomy. A relative told us they had been involved in decisions about the person’s care, and that the local authority was involved when required to support the decision-making process.