Attention: The information on this website is currently out of date and should not be relied upon..

Care Services

carehome, nursing and medical services directory


Downside House, St Boniface Road, Ventnor.

Downside House in St Boniface Road, Ventnor is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and dementia. The last inspection date here was 25th December 2019

Downside House is managed by Downside House Limited.

Contact Details:

    Address:
      Downside House
      3-4 St Boniface Terrace
      St Boniface Road
      Ventnor
      PO38 1PJ
      United Kingdom
    Telephone:
      01983854525

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Requires Improvement
Caring: Good
Responsive: Requires Improvement
Well-Led: Requires Improvement
Overall:

Further Details:

Important Dates:

    Last Inspection 2019-12-25
    Last Published 2018-12-21

Local Authority:

    Isle of Wight

Link to this page:

    HTML   BBCode

Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

9th October 2018 - During a routine inspection pdf icon

Downside House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 21 people, including people living with dementia care needs. There were 17 people living at the home when we visited. Accommodation is spread over three floors, connected by a passenger lift and stairwells. All rooms had en-suite toilet and washing facilities. There is a lounge/dining room on the ground floor and bathrooms on each of the floors.

This inspection took place on 9 and 11 October 2018 and was unannounced.

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 the time of the inspection there was not a registered manager in place. The previous registered manager had left the service in June 2018. At this inspection there was a manager in place who had taken over the overall running of the service, with support from the directors of the provider's company. The manager had commenced the registration process with the Care Quality Commission (CQC).

Risks posed by equipment which could result in significant injury or harm to people had not been assessed or considered. Personal evacuation and escape plans which aimed to keep people safe in the event of a fire were not up to date.

People felt safe living at Downside House and staff knew how to identify, prevent and report abuse and had received training in this area. However, some staff had failed to ensure people were protected from receiving improper treatment.

Oral medicines were managed safely and administered in line with the prescribing instructions. However, systems in place to ensure topical creams were used safety were not effective and clear guidance in relation to when ‘as required’ medicines should be provided was not in place.

The principles of the Mental Capacity Act 2005 were not being followed to ensure people were only cared for with consent; capacity assessments had not always been completed and best interest decisions were not in place for all people that required them.

The systems and processes in place to monitor the quality and safety of the service, were not always robust. There were a number of audits in place to check the quality and safety of the service, however, some of these were not always effective in identifying concerns. People, their families and staff had the opportunity to become involved in developing the service. However, actions were not always taken in a timely way when themes for improvements had been identified.

Staff supported people to be independent; however, changes to the environment had not been implemented to help people further increase their abilities to complete tasks without full support.

There were enough staff to meet people's needs in a timely way and staff were able to support people in a relaxed and unhurried way. People received care from staff who had received an induction into their role, who were competent and suitably trained. However, staff were not consistently supported in their roles as per the provider’s policy.

There was not always a person-centred approach to care and for some people their views and wishes had not always been considered. People’s care files contained individual information about their physical and psychological needs and provided staff with guidance on how people should be supported and what they could do for themselves. However, we found that information for some people about their preferences, likes and dislikes and life history was insufficient.

People were supported to hav

21st July 2016 - During a routine inspection pdf icon

The inspection took place on 21 and 25 July 2016 and was unannounced. The home provides accommodation for up to 21 people, including people living with dementia care needs. There were 18 people living at the home when we visited. Accommodation is spread over three floors, connected by a passenger lift and stairwells. All rooms had en-suite toilet and washing facilities. There is a lounge/dining room on the ground floor and bathrooms on each of the floors.

There was a registered manager in place. 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.

Most risks to people’s safety had been assessed and were being managed appropriately. However, we found risk assessment had not been conducted for people at risk of pressure injuries and there was no process in place to make sure that special pressure-reducing mattresses were kept at the correct setting.

People and their relatives praised the quality of care delivered with end of life care, in particular, being highlighted. Feedback from a family member described this as “tender, tactile, sensitive and sincere”. They said their relative had received a “calm, dignified and comfortable” death. One doctor told us “Downside has the best end-of-life care that anyone could wish for.” Another doctor described it as “exemplary”. Staff also supported relatives of the person dying with empathy and understanding.

Staff showed commitment to people’s well-being by going ‘the extra mile’, for example by taking them to events in their off-duty time. These included shopping, visits to coffee shops and trips to local attractions. Without exception, all the interactions we observed between people and staff were positive. Staff knew people very well and built positive relationships with them.

People felt safe living at Downside House. Staff knew how to identify, prevent and report incidents of abuse. An innovative solution, using a bead curtain, had been found to prevent a person from entering another’s room and putting themselves at risk.

Medicines were managed safely by staff who were suitably trained. The home was clean and there were appropriate arrangements in place for preventing and managing the risk and spread of infection. Plans were in place to deal with foreseeable emergencies.

Recruitment practices were safe. There were enough staff deployed to meet people’s needs. Staff had received relevant training and were supported in their work through one-to-one sessions of supervision and appraisal.

Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. Decisions were taken in the best interests of people.

People enjoyed the meals and were supported appropriately to eat and drink enough. The home was taking part in a pilot project to prevent unnecessary admissions to hospital. This had help ensure people received prompt medical attention when needed.

Care and support were delivered in a personalised and flexible way. People were supported to make choices. Their privacy and dignity were respected at all times. The provider sought and acted on feedback from people and there was an appropriate complaints policy in place.

People and their relatives told us the home was run well. There was an open and transparent culture. Visitors were welcomed, staff enjoyed good working relationships with external professionals and there were strong links with the local community.

There was a clear management structure in place. Staff understood their roles and worked well as a team. Staff described managers was “approachable” and “supportive”.

16th December 2014 - During a routine inspection pdf icon

During our previous inspection in June 2014 we identified concerns in relation to infection control, the management of medicines and quality assurance arrangements. We set compliance actions and the provider wrote to us about how they were going to meet the requirements of the regulations.

During this inspection we found the necessary improvements had been made. We considered all the evidence we had gathered under the outcomes we inspected. We spoke with two people who use the service, the manager and five members of staff. We looked at medication administration records and records relating to the management of the service.

We looked at the areas of infection control, management of medicines and quality assurance. We used the information to answer the questions we always ask;

• Is the service safe?

• Is the service well-led?

This is a summary of what we found:

Is the service safe?

We found the service was safe.

Appropriate arrangements had been put in place to manage infection control risks. Staff had received training, used protective equipment when necessary and followed best practice guidance when handling soiled linen. The provider had a suitable infection control policy in place and a recent audit showed procedures were working effectively.

Medicines were managed safely. All prescribed medicines were in stock, were stored securely and records showed they had been administered as prescribed. Weekly audits were conducted by a senior member of staff and were effective in identifying any discrepancies.

Is the service well-led?

We found the service was well-led.

The provider obtained people’s views by completing an annual survey. This showed people were satisfied with the level of care provided and people’s comments had been used to improve the service. Staff were also encouraged to make suggestions for improvement.

The provider had an effective system in place to regularly assess and monitor the quality of service people received. A range of audits was conducted and these were used to maintain standards. Risks to the health, safety and welfare of people were managed effectively.

13th June 2014 - During a routine inspection pdf icon

During our previous inspection in January 2014 we identified concerns in relation to infection control and the management of medicines and set compliance actions.

During this inspection, we considered all the evidence we had gathered under the outcomes we inspected. We spoke with four people who use the service, three family members of people who were unable to communicate with us due to their mental frailty and six members of staff. We looked at three care plans and records relating to the management of the service. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at the areas of respecting and involving people who used the service, care and welfare, infection control, management of medicines, staffing and quality assurance. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found:

Is the service safe?

We found not all aspects of the service were safe.

Infection control guidance was not always followed. The sluice room and some bedding were not clean. Not all staff were aware of how to process dirty linen safely and one of the cleaners had not received training in infection control.

Medicines were not always managed safely. The provider was unable to account for the use of some medication. The use of creams and ointments was not always recorded and there was no system in place to ensure they were not used beyond their shelf life.

The provider ensured there were sufficient staff with the right skills to meet people’s needs. Risks were managed effectively and equipment required to manage risks, such as walking aids and pressure relieving cushions, was readily available.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service had policies and procedures in place in relation to Deprivation of Liberty Safeguards (DoLS). The registered manager was in the process of seeking a DoLS authorisation in respect of one person. This would ensure their human rights were protected.

Is the service effective?

The service was effective because people were cared for by staff who were knowledgeable about their needs and had the skills to provide appropriate care and support. People told us their needs were met consistently. One person said, “I’m very happy with the care, they’ll do anything for you.” A family member told us “The care is very personalised; [the person] gets all the help they need.” Care records showed people had access to appropriate medical care, including GPs and chiropodists. People’s needs were clearly known and met.

People had access to a choice of suitably nutritious meals. We spoke with the chef, who was aware of people’s dietary needs and those who required their meals preparing in a specific way. For people at risk of malnutrition, we saw food and fluid charts were maintained and their weights were monitored appropriately.

A range of activities was provided by an activities coordinator and we saw people enjoying a ball game and a quiz. The home’s garden had been made accessible to people with limited mobility. We saw this being used during our inspection.

Is the service caring?

We found the atmosphere at the home felt friendly and people were supported in a kind and caring way. One person said of the staff, “They’re very kind and they’ve helped build up my confidence.” Another person told us how staff prepared them for bed in a particular way that gave them “great comfort”. They said, “The staff are wonderful, they’re more like friends.”

We observed care and support being provided in communal areas. Staff interacted positively with people, using people’s preferred names and speaking with them in a calm and respectful way. They took time to sit and engage with people and understand their needs.

Is the service responsive?

The service was responsive to people’s changing needs. We saw assessments were carried out before people moved to the home and their care plans were updated monthly. We spoke with a community health care professional who said of the staff, “They’re very good; they provide good, reliable information and follow through on recommendations we make.”

However, we found that decisions made in respect of people’s ability to manage their own medication were made by staff based on information provided when the person was admitted to the home. No person living in the home at the time of our inspection was managing their own medication. Records did not show whether people had consented to these arrangements or that decisions had been taken in accordance with the Mental Capacity Act, 2005.

Is the service well-led?

We found not all aspects of the service were well-led.

There was a clear management structure in place, including a registered manager; the home benefited from an experienced management team and a low level of staff turnover.

We saw the provider obtained people’s views by completing an annual survey. We looked at the questionnaires used for the latest survey, conducted in April 2013. Family members had also provided feedback. We saw people’s comments had been used to make changes to the environment. The registered manager told us this survey was due to be completed again soon.

The provider took account of complaints and comments to improve the service. Records showed complaints were recorded, investigated and resolved in a timely way. Systems were in place to ensure lessons were learned from incidents.

The registered manager told us they monitored the service informally by working with staff and reviewing care plans. However, the provider was unable to demonstrate the effective operation of systems designed to monitor the quality of services provided. Audits of infection control and medication had not identified the concerns we found during our inspection. This meant people were not protected against the risks of inappropriate or unsafe care.

8th January 2014 - During a routine inspection pdf icon

We used a variety of methods to help us understand the experience of people using the service. We spoke with six people and one family member, and observed care and support being delivered. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We found before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Records of care provided on a daily basis showed times when people had declined care and their wishes had been respected.

We looked at five care plans and related records of care. We saw these were comprehensive and person centred; they provided very clear, detailed information about how care and support should be delivered. People told us their needs were met consistently. One person said, “The staff are wonderful, they are all so kind”. A family member told us “The care is very good; they look after [my relative] well”.

People were cared for in a clean environment and personal protective equipment was used appropriately. However, infection control risk assessments and audits had not been completed. There were no hand decontamination facilities in the laundry room. Staff had not received infection control refresher training in accordance with the provider’s policy.

The management of “as required” medicines was not appropriate. There was no guidance about the use of sedatives and variable doses were not recorded. We found paracetamol and laxatives were not dispensed from each person’s supply, as stock was shared communally. Guidance issued by the Royal Pharmaceutical Society was not being followed.

Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place. People’s personal records including medical records were accurate and fit for purpose. They were kept securely and could be located promptly when needed.

24th September 2012 - During a routine inspection pdf icon

We spoke with 10 of the 20 people who lived at the home. We met other people and spent some time in the home’s communal areas observing people and the way they were cared for. People told us that they could make decisions and that the staff were “very nice”. People said that they had no concerns about how their care needs were met. People commented that they could make choices and these were respected. We were told that staff were available when people needed them and knew what care they required. People told us that they felt safe and happy at the home.

We also spoke with a relative. They were very happy with the care that was provided at Downside House. They told us that they were fully involved in, and informed about, the care their relative was receiving and felt confident in the staff. We spoke with two health professional involved in the care of people. They were complimentary about the way the service met people’s needs. We were told that the home contacted them appropriately and followed guidance and suggestions.

Everyone, people, relatives and other professionals, we spoke with confirmed that people’s privacy and dignity was maintained at all times. We observed that staff were courteous and respectful of people’s views and opinions and that dignity was respected. We saw that people were offered choices about meals, where they sat and activities.

 

 

Latest Additions: