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Inspection on 16/10/09 for Downside

Also see our care home review for Downside for more information

This is the latest available inspection report for this service, carried out on 16th October 2009.

it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Excellent.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: Downside The quality rating for this care home is: The rating was made on: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Gwyneth Bryant Date of this annual service review: 1 0 0 9 2 0 0 9 Annual Service Review Page 1 of 6 Information about the service Address of service: Church Lane Kingston Nr Lewes East Sussex BN7 3LW 01273471604 01273471604 maria.bermingham@googlemail.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category Conditions of registration: Mrs Maria Bermingham Number of places (if applicable): Under 65 Over 65 0 3 Service users must be older people aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is three (3). Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Downside provides accommodation for 3 older people. The home is situated in the village of Kingston, near Lewes in East Sussex. Downside is a large detached bungalow with extensive gardens, to which the residents have access. The owner/manager and her family live on site and provide care to residents. The manager keeps chickens and grows the vegetables eaten in the home. The home adheres to the standards of The British Soil Association and the food provided in the home is totally organic. The manager also keeps dogs and Cats and ponies. Anyone who wishes to live at Downside will need to like animals. Two bedrooms have full en-suite facilities with the other one having a hand washbasin. There is level access to the extensive gardens and the Annual Service Review Page 2 of 6 manager has a vehicle for transporting residents into the wider community. A copy of the homes Statement of Purpose and Residents Guide is provided to anyone making an enquiry about the home. Copies of inspections reports are made available on request. Fees charged range from £370 to £415 which is same for both self funders [private] and those fully funded by Social Services . The higher rate relates to the bedrooms with the en-suite bathroom. Newspapers, trips outs, toiletries, hairdressing and vitamin supplements are included in the fee. Additional charges are made for chiropody. Intermediate care is not provided. The email address is maria.bermingham@googlemail.com. The reader should note that due to the size of this home a number of standards relating to staff and staff training are not wholly applicable as the Manager provides most of the care to residents. The home is also exempt from some fire regulations as resident numbers never go above three persons. Annual Service Review Page 3 of 6 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: * The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. * Information we have about how the service has managed any complaints. * What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. * The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. * Relevant information from other organisations. What has this told us about the service? The home sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. It had been completed and gave us some information on all parts of the service, in addition to some numerical information. It is of concern that the AQAA stated that volunteers brought into the service had been vetted. All people, including volunteers, who have access to service users should provide two written references and a Criminal Records Bureau check. In addition the AQAA indicated that the service does not have policies and procedures for volunteers and therefore there is no guidance available to staff when volunteers enter the service. The Registered Provider has now confirmed that all volunteers have a Criminal Records Bureau check and provide two written references. The previous inspection was completed on 8 November 2007 and an Annual Service Review was carried out on 30th October 2008. The last inspection report was very positive about the service provided with five outcome areas rated as excellent and two as good. No Requirements or Recommendations were made following the visit in November 2007. The AQAA stated that care plans are regularly reviewed and service users and their relatives are consulted on the contents. The home states it is keen to see people receiving a service as individuals and to meet their very individual needs at the outset with a detailed pre admission assessment. This process includes consultation with all interested parties, including healthcare professionals and the provision of detailed information on the service. The home has said that it is good at getting feedback from people living in the home and their relatives and supporters but the information in the AQAA was not clear about how their views were acted upon. The Registered Provider has now confirmed that any suggestions are acted upon with immediate effect whenever possible. The AQAA indicated that one bedroom is in need of redecoration and refurbishment but Annual Service Review Page 4 of 6 this maintenance will not take place at the request of the service user. This indicates that although the home is aware of a shortfall, the wishes of the individual is respected. Other parts of the home are well maintained and service users are able to bring in their own furniture to personalise their bedrooms. Each bedroom has a private telephone line, the cost of calls is not included in the fees. There is a plan to redecorate other parts of the home and provide new carpets. There is one live in carer whose status is self employed but the service carried out all the required checks prior to appointment. The AQAA identified some areas where they need to continue to make improvements to all aspects of the service. However, not all parts of the AQAA gave good details such as the parts asking what the service could do better and what improvements were planned. Some of these parts mostly consisted of a single sentence and did not specify areas of improvements. Although the parts relating to the environment and staffing did include more details. The service has a range of policies and procedures pertaining to the running of the service that are regularly reviewed as part of the quality monitoring process. It is important that the service develops policies and procedures on volunteers as they are used within the home. We looked at the information in the AQAA and our judgement is that the home may not be still providing an excellent service. What are we going to do as a result of this annual service review? As a result of the lack of detail in the AQAA we may change our inspection plan, and do a key inspection before 8th November 2010. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 5 of 6 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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