What the CQC found at Downham Grange

Medicines were administered safely and in a way that responded to people's needs. Staff had training and their competence was checked.

“Medicine administration was person centred with staff being responsive to people's needs and requests for additional medicines as required.” from the report

The home was clean, with regular cleaning records and no unpleasant smells reported. Equipment and the building were regularly maintained.

“The standards of cleanliness throughout the home were high and daily records evidenced regular cleaning.” from the report

Staffing levels met people's needs on the inspection day. Core staff teams were being developed, agency use had reduced and recruitment checks were completed.

“Staff recruitment and retention was improving, and the use of agency staff had significantly diminished.” from the report

The manager was working to improve the culture, develop staff skills and involve families. Families generally said communication and care were improving.

“The registered manager had taken time to get to know the staff and ask them what was working well and what needed improving.” from the report

Topical creams and toiletries were left unlocked in people's rooms. Inspectors said this could cause harm if swallowed, particularly for people living with dementia.

“During our inspection topical creams and toiletries were left unlocked which could cause harm if digested.” from the report

Some daily notes did not clearly explain how people's needs had been met. Staff sometimes used standard wording rather than describing what had happened.

“Some daily notes did not clearly show how people's needs were being met in line with their needs.” from the report

Quality checks had not consistently identified problems or ensured that improvements lasted. Inspectors found that outside organisations had identified concerns instead.

“The provider's quality assurance processes had not always identified service improvements or driven up quality.” from the report

Technical failures affected staff's ability to record care promptly. Extra devices and training had only recently been introduced.

“Problems with accessing and recording care contemporaneously could affect the timeliness of care people received.” from the report

Some relatives were concerned about staffing and delays when entering or leaving the building. Activities varied across the home, especially in the dementia unit.

“We found however people's opportunity to engage in planned activities, varied across the home.” from the report