Down Lodge Residential Care Home

Updated 1 November 2018

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 comprehensive inspection took place on 11 October 2018 and was unannounced. One inspector carried out the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This 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 reviewed previous inspection reports and notifications we had been sent by the provider. A notification is information about important events which the service is required to send us by law.

We spoke with three people and two relatives. We also spoke with the registered manager and three care staff.

We looked at care plans and associated records for four people and records relating to the management of the service. These included two staff recruitment files, records of complaints, accidents and incidents, and quality assurance records. We observed care and support being delivered in communal areas.

The home was last inspected in April 2016 where the service was rated good.

Updated 1 November 2018

This inspection took place on 11 October 2018 and was unannounced.

Down Lodge Residential Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Down Lodge Residential Care Home accommodates up to 16 older people in one adapted building. There were 15 people at the service at the time of inspection, some of whom were living with dementia.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place at the time of our inspection. 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 also the provider. They took a prominent role in the day to day running of the service. The registered manager had a good rapport with people, approaching them with kindness and humour. The registered manager understood their regulatory responsibilities and was experienced and knowledgeable in their role.

There was a calm, warm and friendly atmosphere in the home. There were sufficient numbers of suitably skilled and qualified staff in place. The provider had recruitment processes in place to identify suitable candidates for the role. Staff were well acquainted with people’s needs and were given the opportunity to spend meaningful time with people throughout the day.

People’s care plans reflected how they would like to receive care. The registered manager had developed these plans using information from people, relatives and healthcare professionals.

The provider had an electronic care planning and monitoring system in place. This system was used to effectively monitor people to help ensure changes to people’s health and wellbeing could be quickly assessed.

Staff received training which was relevant to their role. The registered manager monitored staff’s ongoing performance and there were systems in place to ensure staff understood their responsibilities and duties.

People were treated with dignity and respect. Staff understood people’s individual preferences and needs with care organised to help ensure these needs were met. When people received care at the end of their lives, they were given compassionate support which reflected their needs and preferences.

There were a range of activities which people could take part in and people were able to give feedback to the registered manager to suggest new things to do.

Staff understood the need to gain appropriate consent to care. 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 supported this practice.

The home was a clean, hygienic environment, which was suitable for people’s needs. The registered manager carried out a series of audits and checks to help maintain the safety of the environment and the quality of care.

Risks to people’s health were assessed and mitigated. The registered manager assessed people’s needs to help ensure appropriate plans of care were in place. People had access to healthcare services when required and the provider had established effective working partnerships with other stakeholders to promote people’s wellbeing. People followed a diet which was in line with their preferences and dietary requirements.

There were safe systems in place to manage people’s medicines.

When incidents took place, the registered manager looked for trends and lessons that could be learnt to reduce the risk of reoccurrence.

There were systems in place to respond appropriately when people had complaints or concerns. The provider had policies and procedures in place to safeguard people from the risks of abuse or harm.