We carried out a review of the data available to us about Gorselands Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gorselands Nursing Home, you can give feedback on this service.
Gorselands Nursing Home is a residential care home providing personal and nursing care to 39 people aged 65 and over at the time of the inspection. The service can support up to 40 people. The service provides nursing care for people in an adapted country house.
People’s experience of using this service and what we found
There were robust systems in place to protect people from the risk of abuse and staff would report concerns should they have any. Risks were assessed and mitigated to minimise the possibility of harm. The premises were safely maintained, and equipment was serviced as needed. There had been an improvement to recruitment processes and staff were safely recruited. Medicines were safely managed and should errors occur, these were reported and reflected upon. Infection prevention and control practice was strong and in line with current guidance. Learning was taken from accidents and incidents and shared among the team to minimise the possibility of repeat events.
Most feedback about the management of the service was positive and the registered manager had frequently supported the team by working alongside them when there was a staff shortage. The management team were open and honest and understood their responsibilities under the duty of candour. Audits were completed and used to make improvements to service provision. Steps were being taken to improve the integration of the service into the local community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 1 November 2019). At this inspection we found improvements had been made.
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gorselands Nursing Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Gorselands Nursing Home is a residential care home providing personal and nursing care to 39 people aged 65 and over at the time of the inspection. The service can support up to 39 people.
Gorselands Nursing Home accommodates 39 people in one adapted building. The property has additional activity and office space in log cabins in the extensive grounds.
People’s experience of using this service and what we found
Medicines were safely administered. Available audits were unclear; however, we saw that registered nurses would reconcile stock and ensure that documentation was completed. A new medicines audit had been introduced and would be completed from August onwards. Topical medicines were not well recorded, and we have made a recommendation about this in our report.
There were limited records available to indicate how safeguarding concerns and accidents and incidents had been dealt with. New documentation had recently been added and there was now a clear process to deal with concerns.
Improvements were immediately made to the premises when we identified concerns. Premises safety checks were current and thorough and additional new, more detailed checks had been set up for wheelchairs, walking aids and other equipment.
Staff were safely recruited. Some staff records lacked a full employment history however these were obtained by the manager before we finished our inspection. Staff told us there were sufficient staff.
A new infection control champion had been identified and had begun to complete audits of hand washing. We saw that some staff wore wrist watches and there was a communal nail brush in the staff bathroom. We have made a recommendation about infection control.
New audits of accidents, incidents and falls had been completed in July 2019 and were accompanied by thorough incident reports.
An electronic care record was in place which generated risk assessments as people’s needs were added to the system. Care plans had been personalised however some significant information was missing. We have made a recommendation about care plans.
Staff had not received regular planned supervisions, these had been on an ad hoc basis. A new supervision arrangement was in place and some responsibilities delegated to registered nurses and senior care staff.
Training had been reviewed and a new provider would be used for online training. Additional face to face training had been identified.
People were generally very happy with the food provided and meals were prepared according to people’s needs and wishes. One relative was unhappy with food provision, so this would be discussed at the next residents and relatives meeting.
Staff worked with health care professionals to maintain people’s health and well-being, and care plans reflected people’s specific requirements.
The premises were a converted country house in a large garden. The grounds were monitored by CCTV and a keypad entry system was being added to secure the building.
Décor was plain and lacked dementia friendly signage.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care was person centred and reflected people’s diverse needs. People felt cared for and we saw appropriate, caring interactions.
When possible, people were included in care planning and there had been a resident and relatives meeting introduced.
Staff were respectful of people and told us how they maintained people’s dignity when delivering care.
Confidential information was securely stored.
People's needs were assessed before admission into the home and information was gathered about life histories to enable staff to have relevant conversations with them.
Communications needs were identified and met, and consideration was given as to how people liked to receive information.
An activities coordinator and a well-being coordinator supported people with activities and there were regular trips out using the services minibus.
There was a complaints procedure and recent complaints had been dealt with accordingly.
There was no one receiving end of life care when we inspected. The service had discussed this with some people and some care records showed end of life plans.
For more details, please see the full report which is on the CQC website at
Rating at last inspection
The last rating for this service was good (published 6 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Gorselands Nursing Home provides accommodation, nursing care and support for up to 39 people. At the time of the inspection the service had 39 people living there.
The service had a registered manager. 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 caring ethos of the service was outstanding. People were extremely happy with the care and support they received. One person said, “I couldn’t think of anything that could improve” and another person told us, “I am very happy here. The staff are extremely helpful and kind. The food is absolutely delicious. I have nothing to complain about. I'm very very comfortable and so fortunate to be here”.
Staff told they were well supported and had the right knowledge and skills to provide caring and effective care or support and described how they provided individualised care and support. For example, one member of staff said, “We provide very good care by forming a personal relationship with people. Its very person centred here. For instance, if somebody comes in with a very set routine as we have just had, we alter the daily allocations to incorporate her own routine”.
The service had safe systems in place that ensured people were protected from harm and received care that met their needs.
People were supported and provided with an extensive choice of healthy food and drink ensuring their nutritional needs were met. Menus took into account people’s dietary needs and people told us they really enjoyed the food and could ask for different choices if they did not like what was on the menu.
There were lots of individual and group activities. People told us there was enough going on and they didn’t get bored.
People told us that staff responded promptly to their requests for assistance and that staff supported them to see healthcare professionals quickly when they needed to.
People knew how to make a complaint and felt confident they would be listened to if they needed to raise concerns or queries. There was a clear system in place for people to raise concerns and complaints.
There was an effective approach from the manager that supported staff to provide very person centred, effective and responsive care. There were comprehensive quality assurance mechanisms in place that meant people and staff were able to express their views and these were acted upon to drive continuous improvements.
People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.
We reviewed care plans for five people and they were person centred and contained essential details about people's care and support needs. Staff were observed supporting people using the service and always used their first names. During the inspection we observed one person being spoken to using their surname and title and upon checking their care plan we saw that they prefered to be addressed this way rather than the use of their first name. This showed that people's choices were respected and acted upon.
Staff were well supported and received on-going training and development to be able to effectively meet people's support needs.
People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Observation during the inspection showed staff supporting people to make their own choices.
People experienced care, treatment and support that met their needs and protected their rights. Care plans were person centred and documented people's wishes in relation to how their care was provided. We observed that people chose how to occupy themselves in the home.
People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We spoke with staff and staff demonstrated an understanding of the safeguarding procedures and the different forms of abuse.
During our inspection we did not see evidence that staff had been provided with adequate and appropriate supervisions, personal development and an induction to the home.
People that we spoke to were happy living at the home and enjoyed the variety of activities and food choices on offer.
People's relatives that we spoke to were happy that their relatives lived in such a welcoming and friendly home.
All comments received from people receiving a service were positive.
Staff told us that improvements had been made in the monitoring of the administration of medicines and that checks are made for accuracy. Qualified staff members have a role in ensuring any errors are picked up are addressed.
Staff also told us about improvements to some of the recording and this included their role in updating and reviewing care plans.
People told us that they are supported with health and personal care and are aware of care plans. Social stimulation is also provided. A range of activities are offered in groups and for individuals.
Feedback was very positive about the staff who are reported to be generally attentive friendly, helpful, aware of needs and well organised. Staff told us about recent changes made to the organisation by allocating key workers to ensure that individual needs are followed and reviewed.
People told us that staff are busy but generally available to meet their needs. Sometimes they had to wait but reasons were explained.
People told us that the food is generally very good. Choice of food is always provided and people are asked in advance but if they change their mind alternatives are available. People can choose where to eat, are helped and relatives can stay for meals. Staff told us that food and fluid intake is monitored.
People are confident that they can ask for things they need, can raise issues and that these will be addressed and they gave us examples of these.
People and relatives told us about being consulted about the home and about recently being asked to complete a questionnaire. Staff can also give feedback.
People and relatives told us that the home is always clean and free from odours.
People are aware that staff are provided with equipment for infection control. They were positive about the internal and external environment which is pleasant to look at. They are comfortable and warm. Equipment needed is available and staff told us they are trained in moving and handling.