We carried out a review of the data available to us about Downs View Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Downs View Care Centre, you can give feedback on this service.
Downs View Care Centre is a residential care home providing the regulated activity of accommodation for persons who require nursing or personal care. The service is capable of supporting up to 51 people. It provides support to older people, young adults, people with physical disabilities, people living with dementia and people with mental health needs. At the time of our inspection there were 33 people using the service.
People’s experience of using this service and what we found
Assessments of people's needs had been carried out prior to people using the service. People were supported to eat and drink a balanced diet and had a choice of meals, snacks and drinks. Staff training was relevant and up to date. The provider sought healthcare advice from a multi-disciplinary team of professionals when required.
People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible. The policies and systems in the service promoted this practice.
People were treated with kindness and compassion and were encouraged to be as independent as possible. Care plans contained detailed information on people's life history and included information on people's memories, employment and family.
People were supported to take part in a variety of activities and hobbies both inside and outside of the service. People's communication needs were known and met by staff who knew people well. People, their relatives and staff were asked for their opinions of the service and action was taken to make improvements. Complaints were recorded and investigated.
All aspects of the service were regularly audited. There was a positive, person-centred approach to the planning and provision of people's care. People, their relatives and staff all spoke positively about the management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 8 September 2022).
Why we inspected
This inspection was prompted by a review of the information we held about this service showing the service may have improved.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Downs View Care Centre is a residential care home registered to provide accommodation and personal care to elderly people. At the time of our inspection there were 22 people using the service. Downs View Care Centre can support up to 51 people.
People’s experience of using this service and what we found
Improvements have been made in the safe and well-led domains. People were cared for by staff who were trained to promote people's safety and understood safeguarding procedures. Risks to people's lives had been assessed and kept under review. Care plans were person centred and staff understood how to manage risks to people. Medicines were administered by appropriately trained staff in a safe manner. Staff worked in partnership with health care professionals to promote good outcomes.
There were sufficient staff deployed to meet people's needs. People and their relatives said that there were enough staff to support people. Environmental risks were assessed, and the premises and equipment used to promote people's safety were clean and well maintained. Staff followed infection prevention control measures to ensure the risk of infection was managed.
People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible. The policies and systems in the service promoted this practice.
People, their relatives and staff said the registered manager was visible and approachable. The registered manager had a robust governance and auditing system in place. Audits were up to date and identified any lessons learnt following incidents and accidents so action could be taken to keep people safe. A learning culture was in place when things went wrong.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 31 May 2022)
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found sufficient improvements had been made and the provider was no longer in breach of regulations.
This service had been in Special Measures since 17 March 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Downs View Care Centre on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
About the service
Downs View Care Centre is a residential care home registered to provide accommodation and personal care to older people. At the time of the inspection 38 people were using the service. Downs View Care Centre can support up to 51 people.
People’s experience of using this service and what we found
Risks to people's safety had not been well managed. A range of risks to people had not been
properly assessed or managed. Opportunities to learn from events had been missed and people's health needs had not always been followed up.
Medicines were not well managed. Medicines administered ‘when required’ (PRN) protocols lacked person-centred detail on when the medicine should be administered.
Infection prevention control measures were not always embedded and required improvement. PPE was not consistently used appropriately.
Staff training and induction was not adequate to provide staff with the guidance and skills to safely carry out their roles. Some people lived with diabetes, no staff had undertaken diabetes training.
Records were not kept to show how decisions were made in people's best interest. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
There was insufficient oversight of the service by the provider to pick up and address the risks found by inspectors. Records and communication with other professionals were an area of concern across the service. Information from healthcare professionals was not always recorded and followed up by the service. The provider had failed to make improvements and the service had declined in quality.
People and relatives told us the food was good and met their needs. Mealtimes continued to be a social occasion where most people ate at dining room tables and had the opportunity to interact with staff and chat together.
Staff were recruited safely. Disclosure and Barring Service (DBS) criminal record checks were completed as well as reference checks.
Following our inspection the registered manager stepped down and left the service. The provider introduced a voluntary admissions embargo in order to focus on overall improvement of the service. They produced an action plan on how they plan to address issues raised during this inspection and shared this with us.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 August 2021). Two breaches of regulations were found in relation to safe care and treatment and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This inspection was also prompted by our data insight that assesses potential risks at services, concerns in relation to aspects of care provision and previous ratings.
The inspection was also prompted in part due to concerns received from other healthcare professionals about people's safety and lack of communication with the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review all the key questions review the key questions of Safe, Effective, Responsive and Well-led only. This enabled us to review the previous ratings.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements.
You can see what action we have asked the provider to take at the end of this report. Please see the Safe, Effective, Responsive and Well-led sections of this full report.
The overall rating for the service has changed from Requires Improvement to Inadequate. This is based on the findings at this inspection.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified six breaches in relation to person-centred care, need for consent, safe care and treatment, good governance, staffing and notification of incidents at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures:
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Downs View Care Centre is a residential care home registered to provide accommodation and personal care to elderly people. At the time of the inspection 43 people were using the service. Downs View Care Centre can support up to 51 people.
People’s experience of using this service and what we found
Medicines were administered safely, however, they were not always stored safely.
Risk assessments and care plans were in place for each person. Although risks to people had been identified, the steps to be taken to deal with those risks were not always clear. Care plans did not always give enough detail to staff to enable them to manage those risks.
People’s social needs were assessed, however, social activities were provided irregularly for people who were bed bound. Some people’s relatives told us they had concerns regarding lack of person-centred and dignified care and poor communication with the service.
The service completed audits and checks; however, these were not always effective at identifying concerns.
People were protected by the provider's recruitment procedures. The provider made appropriate pre-employment checks to ensure that only suitable staff were employed. Staff understood their responsibilities in terms of safeguarding and knew how to report concerns if they suspected abuse.
Within the context of Covid-19 infection risk, procedures were in place to ensure infection control was managed. Staff understood their responsibilities to reduce the risk of spread of infection.
The home had a robust complaints policy and records showed complaints were responded to in line with it. People and their relatives told us they knew how to make complaints.
Staff praised the registered manager who promoted a culture of openness and transparency within the service. The registered manager worked alongside professionals to ensure people's health and wellbeing were maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 19 March 2020).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about incidents between residents, alleged neglect, poor catheter care and poor management of medicines. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with poor storage of medicines, care planning and risk assessments so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, caring, responsive and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions, therefore we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from outstanding to requires improvement. This is based on the findings at this inspection
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breach in relation to safe care and treatment at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.
Downs View Care Centre is a residential care home registered to provide accommodation and personal care to older people. At the time of the inspection 43 people were using the service. Downs View Care Centre can support up to 51 people.
People’s experience of using this service and what we found
People using the service felt safe. People looked relaxed, happy and comfortable with staff, and they interacted well with each other. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. Individual risk had been considered and planned into care.
There were sufficient staff on duty to meet people's needs. The service used some agency staff, in limited numbers, to cover any shifts. The agency staff worked only at Downs View Care Centre to prevent spread of the Covid 19 virus.
The home was clean and odour free. People were protected from the spread of infection. Staff had access to personal protective equipment (PPE) and had received training in how and when to use it effectively. Cleaning and infection control procedures had been updated in line with Public Health England (PHE)
Covid-19 guidance to help protect people, visitors and staff from the risk of infection. Staff were required to wear uniforms once in the building and change out of their uniforms before leaving the premises to mitigate infection risks. There were systems in place to ensure lessons were learned and these were used to improve practice within the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 19 March 2020).
Why we inspected
We undertook this targeted inspection to check on a specific concern we had received about staff not wearing appropriate PPE, poor infection prevention control arrangements and lack of staff training. Other issues of concern we received included personal care not given in a timely manner, allegations of regular abuse and allegations of falsified monitoring charts. The overall rating for the service has not changed following this targeted inspection and remains outstanding.
The CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm resulting from these concerns. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.
Downs View Care Centre is a residential care home registered to provide accommodation and personal care to older people. At the time of the inspection 44 people were using the service. Downs View Care Centre can support up to 51 people.
People’s experience of using this service and what we found
People received exceptional support from caring staff who knew people very well. People’s independence was strongly encouraged and people were thoroughly involved in making decisions about their care. The provider set out exceptionally caring values and there was evidence that all staff worked to this aim as people were at the heart of the service delivery.
The manager was extremely passionate and dedicated to providing person-centred care. They led their staff by example, mentored, motivated and inspired them.
The arrangements to provide activities were excellent. This enabled people to pursue their own interests and hobbies. There was an emphasis on encouraging social connections within the local community and people’s families. Activity coordinators were extremely passionate and worked with staff to create activities to ensure people were not isolated. There was a new system in place to assess and provide person-centred activities on the level preferred by people.
Staff were very proactive and responsive to meeting people's changing needs. Staff knew people’s needs well and therefore they were able to provide personalised support which significantly enhanced people's lives. The care and support people received enabled them to achieve positive outcomes such as being more in control of their life.
The design and décor, both internal and external, reflected evidenced-based best practice standards for creating an environment that supported people living with dementia and memory impairments.
Staff treated people and their relatives with utmost kindness and provided extra time for people to support them when they were in distress or feeling anxious. This quality was acknowledged in compliments received from relatives.
People were protected from the risk of harm and abuse. There were risk reduction measures in place to protect people's health, safety and well-being. People's medicines were well managed. Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social needs were met.
People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and in their best interests; the policies and systems in the service encouraged this practice. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.
Emphasis was given to making sure people got enough to eat and drink, and food was presented in an appetising way.
The service worked in partnership with other organisations and kept up to date with new research and development to deliver the latest best practice. There was a robust quality assurance process embedded throughout the service. Regular checks and audits were carried out to monitor the safety and quality of the service. People received care from staff who were well trained and well supported by the manager.
The premises were safe, and the home was clean and comfortable. Any accidents or incidents were fully investigated and reported as required. Lessons learned were shared with staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Downs View Care Centre provides accommodation and personal care to up to 51 people, some of whom have dementia. At the time of our inspection, there were 42 people living at the home.
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 registered manager was available throughout our inspection.
There were sufficient staff to support people effectively. Staff spent time with people and were able to undertake tasks in a relaxed manner, without rushing. New staff had been recruited using safe recruitment practice.
Improvements had been made to the cleanliness of the home. All areas, including those less visible, were clean. Cleaning schedules had been reviewed and a new post of head housekeeper had been introduced.
People felt safe and potential risks had been identified and addressed. Staff were aware of their responsibilities to identify and report any suspicion or allegation of abuse.
Medicines were safely managed and regularly audited to minimise the risk of error. People received good support from a range of health care professionals. Specialist services were requested as required.
Clear focus was given to food and its impact on wellbeing. Meals looked appetising and were based on people’s needs and preferences. People received frequent drinks and snacks throughout the day. Potential risks of malnutrition and dehydration were well managed.
Staff supported people in a caring, friendly and attentive manner. Frequent interactions demonstrated the positive relationships which had been established. People clearly benefited from the attention shown to them.
People were involved in a range of meaningful activity which was arranged in accordance with their ability and personal interests. There was a positive, stimulating environment within the home.
Staff were responsive to people’s needs and rights to privacy, dignity and choice were promoted.
People had a plan of their care, which was up to date and regularly reviewed. Whilst care plans, demonstrated the support people required, some areas lacked detail. Terms such as “regularly” were used, which did not provide staff with clear guidance to ensure the timing of care, met people’s needs.
People and their relatives felt listened to and were encouraged to give their views about the service. They were aware of how to make a complaint and were confident any issues would be properly addressed.
Staff received a range of training and felt well supported. There was a willingness to learn, develop and further improve the service people received.
Improvements had been made to the environment. Corridors were now more attractive due to sensory items and people’s artwork. People’s outdoor space was being extensively developed.
The home benefitted from clear leadership and organisational systems were well managed. Comprehensive auditing ensured any shortfalls were quickly identified and resolved.
We carried out this inspection over two days on the 15 and 17 December 2015. The first day of the inspection was unannounced. During our last inspection on 18 July 2014, we found the provider satisfied the legal requirements in the areas we looked at.
Downs View Care Centre provides accommodation and personal care to up to 51 people, some of whom have dementia. At the time of our inspection, there were 45 people living at the home.
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 registered manager was available throughout our inspection.
There were some concerns about some aspects of care people received. A night monitoring visit had identified some people were supported to get up very early and did not have access to a drink. This poor practice was appropriately addressed by the registered manager. Further monitoring visits identified no concerns although records had not been completed to evidence this. The registered manager told us further consideration would be given to ensure staff were more proactive, to minimise potential issues.
More intricate, less visible areas of the home were not clean. Such areas included the frames of wheelchairs, the beading on over-bed tables and the hinges of toilet seats. Records showed cleaning schedules were in place and being monitored.
Staffing levels were sufficient to meet people’s needs. However, there was often staff sickness which made shifts difficult to cover. Various initiatives had been implemented to improve staff attendance but these had not been as efficient as expected. Agency staff were being used and there was ongoing recruitment to increase the flexibility of covering for staff absences.
There were many positive interactions between staff and people who used the service. However, there were some interactions which could be improved upon. Some people received little interaction and stimulation from staff. Improving social activity provision was an area the registered manager was looking to develop.
The environment was in the process of being developed. This included a large lounge extension and office area, leading to a newly developed secure, sensory garden. Another lounge had been decorated with new furniture. There were plans to develop those areas, which provided a lack of sensory stimulation. This included the corridors, within one area of the home.
Staff responded quickly to people’s call bells and specific issues such as an altercation between two people who used the service. People looked well supported and their rights to privacy and choice were promoted. People’s needs were appropriately assessed and any potential risks were identified and minimised. Each person had an up to date care plan, which informed staff of individual wishes and the support required. There were management plans in place to help staff support those people who had behaviours that challenged.
People were offered a variety of choice at meal times. The lunch time meal looked appetising and was well presented. Individual preferences and specialised diets were provided. Those people at risk of malnutrition were appropriately assessed and monitored. People were regularly weighed and given increased calorie intake if required.
People had access to a range of services to meet their health care needs. This included regular visits from the GP, district nurse and community matron. People received support to attend hospital appointments, as required. People received their medicines in a safe and person centred way. Staff received training in the management of medicines and had their competency regularly assessed. This ensured staff were competent in their role.
Staff were well supported by managers and each other. They received regular meetings with their supervisor, to discuss their performance and any concerns they might have. Staff undertook regular training to ensure they had the knowledge and skills to do their job effectively. However, housekeeping staff had not received training in dementia care. This training would increase staff’s knowledge and therefore enhance people’s experiences.
People were supported by staff who had undertaken a thorough recruitment process. This ensured all staff were suitable to work with vulnerable people. Staff had received safeguarding training and were aware of their responsibilities to recognise and report abuse.
There was an effective auditing system to assess and monitor the quality and safety of the service. The registered manager submitted a monthly report to senior managers to ensure further monitoring. People were encouraged to give their views about the service. This was informally, at meetings or by using questionnaires. The feedback received was used to help improve service provision. People knew how to make a complaint and were confident any issues would be properly addressed.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with three people using the service, their relatives, seven staff, the manager and the operations manager. We reviewed five care plans and other relevant records. Additionally we used the Short Observational Framework for Inspection (SOFI) observation for a forty minute period. SOFI is a specific way of observing care to help us to understand the experience of people who could not, clearly, tell us about it.
Is the service safe?
Care plans instructed staff how to meet people's needs in a way which minimised risk for the individual. They were detailed and ensured staff cared for people in a safe way.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home liaised effectively with the local authority DoLS team and had made applications as appropriate. The home had made eight DoLS referrals and extension applications in 2014.
We found that medication was administered and recorded in a way which kept people as safe as possible. Staff were properly trained and their competence to administer medicines was checked regularly.
The home trained and supported staff to enable them to work effectively with vulnerable people. People told us they had never experienced any poor treatment and felt safe in the home. The home referred staff to the appropriate bodies if they were not fit to work with vulnerable people.
Systems were in place to make sure that the manager and staff continually monitored the quality and safety of care offered to people.
Health and safety was taken seriously by the home and all the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.
People told us they felt very safe in the home. One person said: 'there's no abuse here, I've seen the films and it wouldn't happen here'. Families told us that they had: 'absolutely no concerns' (In regard to people's safety).
Effective?
People's health and care needs were assessed with them, and/or their relatives, as appropriate. Care plans were detailed and clearly identified people's needs and how they should be met. They were reviewed regularly and changes were made to meet people's changing needs. We saw that staff gave support as described in individual's care plans.
We observed staff meeting people's needs in an effective way and people told us they felt the home met their needs. Relatives said that the home met their family member's needs.
Caring?
People were supported by kind, caring and patient staff. We saw that care were attentive, encouraging and positive. One person described staff as: 'kindness itself'. They responded appropriately to people's needs. Staff communicated with people at all times and encouraged interactions between people using the service.
People's diversity, values and human rights were respected. Care plans were individualised and person 'centred. We saw that people were treated with respect and dignity by the staff.
Responsive?
We saw that health care was sought in a timely way and the home co-operated with other health care professionals to make sure their health care needs were met.
The home had made changes and improvements as a result of ideas and discussions with people who lived in the home and their relatives.
Well led?
We saw that staff were supported to do their job and meeting the needs of the people who lived in the home was the priority.
The service had an effective quality assurance system. We saw records which showed that identified shortfalls and ideas people put forward were addressed. Several examples of changes made as a result of the regular satisfaction surveys were provided by relatives and the manager. As a result the quality of the service was being maintained or improved.
People who lived in the home we spoke with told us they were well treated by the staff and were happy with the care and support that was provided. We observed staff interacting positively with people in a caring and professional manner.
The senior staff had undertaken training around the positive management of challenging behaviours. We were told how this input would be cascaded through the staff team.
The home had introduced improvements to the management of infection control. Additional auditing and checks had been introduced of the cleaning that was completed. The home had also sought advice and guidance from outside agencies. The latest appropriate formal guidance from the Department of Health was in place for staff to reference. There were plans to identify a staff member to take a lead role for infection control.
We found that the home was clean and mainly free form odours. The individual rooms appeared clean and hygienic and people who lived in the home we spoke with told us they were happy with the way their bedrooms were maintained and cleaned. We found that some improvements could still be made to parts of the communal areas.
We found that people were provided with a varied choice of food and that nutritional needs were being monitored. People who lived in the home we spoke with told us they enjoyed the food.
We found that people enjoyed the activities that were organised
We found that while the home was generally clean and well maintained improvements were needed to the management of infection control.
The home had sufficient care and ancillary staff on duty to meet the needs of the people living in the home.
We saw that improvements had been made to the management of records.
People who lived in the home told us that they were given choices about their treatment or care. The home had a range of activities which people could join in with. People told us that they were given a choice of food at each meal time.
People told us they felt safe when staff needed to use equipment when assisting with their care.
Staff had completed regular training appropriate to their roles. Staff told us they were well supported by their manager and colleagues.
We found that the records kept by the provider were not always up to date.
People appreciated the care that they received from staff. They had care plans which helped to ensure that staff provided support in a consistent way.
Relatives said that they were made to feel welcome and could pass on their views to the manager. A newsletter was produced which helped to keep people up to date and informed of new developments. We were told that one priority was to increase the support that people received with activities during the day.