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Downham Grange nursing home in Downham Market placed into special measures by CQC after inspection found it inadequate – but Kingsley Healthcare feels rating is ‘unfairly harsh’





A nursing home in Downham has been placed into special measures after inspectors rated it ‘inadequate’.

In a report published today, the Care Quality Commission (CQC) dropped the overall rating for Downham Grange from requires improvement to inadequate, following inspections in June and July.

Inspectors said they were concerned that the home, which provides accommodation and personal care for up to 62 people, “did not prioritise health and hygiene” and stated that they felt some of the home’s residents were “not being protected from risk of harm”.

Downham Grange Care Home has been placed into special measures after inspectors rated it ‘inadequate’
Downham Grange Care Home has been placed into special measures after inspectors rated it ‘inadequate’

While a spokesperson for Kingsley Healthcare Group Ltd, which runs Downham Grange, said the shortcomings highlighted in the report are being treated as “valuable lessons”, they said they feel that the inadequate rating is “unfairly harsh”.

The report states that the inspection, which took place over two days and included an ‘expert by experience’ – someone who has personal experience of using or caring for someone who uses this type of care home – also found the home to be inadequate in terms of how safe and well-led it is.

Its ratings for how effective, caring and responsive were not looked at this time, so they remain good.

Inspectors said they were concerned that the home “did not prioritise health and hygiene” and stated that they felt some of the home’s residents were “not being protected from risk of harm”
Inspectors said they were concerned that the home “did not prioritise health and hygiene” and stated that they felt some of the home’s residents were “not being protected from risk of harm”

As CQC has placed it into special measures, this means Downham Grange will be kept under close review and reinspected to check on the progress of improvements.

Gill Hodgson-Reilly, CQC’s deputy director for the East of England, said: “When we inspected Downham Grange we were concerned to find a home where health and hygiene were not prioritised.

“We found equipment, such as crash mats, wheelchairs, pressure cushions and items of furniture were visibly unclean, some people’s bedrooms had malodour, and some flooring and surfaces were damaged, impacting on the ability to keep these areas clean.”

She said some people were not being protected from risk of harm, as items such as razors and denture cleaning tablets were not securely stored in some of the rooms.

A spokesperson for Kingsley Healthcare Group Ltd, which runs Downham Grange, said they feel that the inadequate rating is “unfairly harsh”
A spokesperson for Kingsley Healthcare Group Ltd, which runs Downham Grange, said they feel that the inadequate rating is “unfairly harsh”

“This was of particular risk for those people living with dementia, who relied on the staff to maintain their safety,” she added.

“What food and drink people had consumed was not well recorded, which is a particular risk to people with diabetes who need to eat and drink regularly to stay healthy.

“We also found that people didn’t always get the medication they needed, with medicines running out and not being reordered and some creams out of date but still being used and there were gaps in recording medicine use. The home has since assured us they are working with GPs and pharmacies to resolve this issue.”

She said there were particular concerns regarding staffing levels in the evenings.

“Although staff were responsive to people’s needs, the home was regularly understaffed, which was particularly concerning at night time where there was often one instead of two nurses available to deal with people’s complex medical needs.

“We are considering what further regulatory action to take to keep people safe and we will report on this when we are able to.”

Inspectors said they also found that:

  • People did not always receive support from suitably trained staff. New staff were not receiving thorough inductions and support
  • As there was no registered manager at the time of the inspection, the provider should have been providing oversight of the service, which inspectors found lacking
  • Some people had unclean fingernails, and there was a lack of records to show people’s nails or teeth were being regularly cleaned
  • People with risks of developing pressure sores or at risk of chocking were poorly managed

Despite this:

  • People and their relatives told inspectors they felt safe living at the service. They saw staff were responsive to people, for example if they were upset or needing reassurance
  • People were able to spend time with relatives and friends inside and outside of the service, as well as accessing the local community

A spokesperson for Kingsley Healthcare said: “We are proud to have operated Downham Grange as a luxury, purpose-built care home for over a decade, building the trust and support of the local community in that time.

“We are therefore disappointed by shortcomings highlighted in our latest CQC report but want to give a firm assurance that these have been treated as valuable lessons by the care home staff and wider Kingsley team.

“We are swiftly implementing the necessary changes, ensuring they are embedded in our practices, to ensure we continue to provide the high quality care our residents and their families expect.

“However, we disagree with a number of points raised by the inspectors and feel that their overall inadequate rating is unfairly harsh and does not accurately reflect the level of care we pride ourselves on delivering.”

They apologised to residents and families for any anxiety or distress caused by the report, and offered reassurances that none of the shortcomings had caused harm to any of the residents.

“The inspectors' visit came during a difficult time of management transition at the home but we now have a new team in place and a full complement of staff,” they added.

“We welcome people to visit Downham Grange and assure themselves about the quality of the home and the standard of care.

“We have already held positive meetings with residents, their families and stakeholders and to ensure transparency and openness, we are providing weekly updates on the progress of our changes to residents and their families.

“We welcome anyone who has any concerns to visit the home and satisfy themselves on the quality of our service.”

The spokesperson went on to say that they feel some of the points raised are not proportionate to the identified issues, with one example being that the conclusion regarding health and hygiene was made based on ants being found in one bedroom of 62 and two residents out of 56 having unclean nails.

“We provide person-centred care and the razor and denture tablets were in the washbag of a resident who has mental capacity and wanted them left in their bathroom. We therefore challenge the “risk of harm” claim,” they added.

“We categorically refute the claim the home was left under-staffed as we use the recognised Barthel dependency tool to determine staffing levels. Nevertheless, we have reviewed and strengthened our management structures and put an additional nurse in place at night-time.”

A “robust action plan” has been put in place to address the CQC’s concerns, while monthly meetings for residents and their families are also being held.

“We want to reassure them that we are determined to get everything right and are encouraged by the reassuring and helpful comments conveyed to our team at the home,” the spokesperson added.

“We feel the overall report and rating are harsh and disproportionate.

“Downham Grange is certainly not an inadequate home and this is supported by the observations in the report that residents and their families “felt safe living at the service” and that staff were responsive to people, for example if they were upset or needing reassurance”.”



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