We carried out a review of the data available to us about Garsewednack Residential 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 Garsewednack Residential Home, you can give feedback on this service.
Garsewednack Residential Home is a residential care home that provides care and accommodation for up to 21 older people, some of whom were living with dementia. At the time of the inspection there were 18 people living in the service.
People’s experience of using this service and what we found
Staff and the registered manager were kind, caring and compassionate. People were supported to maintain their independence and staff acted to ensure people’s dignity was protected.
Although the service had a number of staff vacancies, people had received the support they needed. Rotas showed staff and the registered manager were completing additional shifts to ensure planned staffing levels were achieved. People told us, “There are enough staff” and reported that staff responded quickly to any requests for assistance or support.
Recruitment was ongoing and records showed all necessary checks had been completed to ensure new staff were suitable for employment in the care sector.
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. The registered manager and staff team had a good understanding of the Mental Capacity Act 2005 and consistently acted in people’s best interests.
Peoples needs were assessed and identified before they moved into the service and the service had appropriately supported people to access external healthcare professionals. Risks in relation to people’s support needs had been identified and managed appropriately to protect people from the risk of harm.
People were complimentary of the food and all staff had a good understanding of people’s nutritional needs and dietary preferences.
The premises were clean and reasonably well decorated. Necessary safety checks had been completed by appropriately qualified external contractors.
The service was well led. The registered manager provided effective leadership and staff reported they were well supported. Quality assurance systems had identified that staffing pressures and restrictions associated with the Covid- 19 pandemic had impacted on training updates and the quality of some record keeping. Appropriate plans had been developed to address and resolve these issues prior to our inspection. A staff member, on restricted duties, had been allocated the responsibility for addressing the recording issues and additional in house and external training had been arranged.
We were assured that risks in relation to the COVID-19 pandemic had been managed appropriately. Staff had access to PPE and hand washing facilities, which they used effectively and safely. Regular testing was underway we were assured there were appropriate procedures in place to prevent the spread of the infection.
Medicines were managed safely, and people received their medicines on time and as prescribed.
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 good. (Report published on 3 April 2019).
Why we inspected
Prior to the inspection we received information of concern in relation to the service’s admissions processes and management of risks in relation to hydration and nutrition. As a result, we carried out a focused inspection to review the key questions of safe, effective and well-led only.
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 remained good. This is based on the findings at this inspection.
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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link on our website at www.cqc.org.uk.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
We found the following examples of good practice.
At the time of the inspection, due to lockdown rules, visiting was extremely restricted. Staff supported people to use video technology to keep in touch with relatives.
When permitted, visitors to the service were greeted at a designated entrance to the premises. Here there was clear information displayed about the measures in place to protect people, staff and visitors from the risk of infection.
The premises appeared clean throughout. Domestic staff hours had been increased to help ensure cleanliness standards were maintained throughout the day. Cleaning schedules were completed to evidence all areas of the building had been cleaned.
Residents and staff adhered to social distancing rules. A dining room had been identified as underused and had been set aside for staff to use for handovers and breaks.
An infection control policy and Covid -19 risk assessment contained clear guidance for staff on the actions to take to minimise the risk of cross infection. Staff had completed relevant training.
The registered manager carefully considered everybody's needs before admitting any new residents to the service. New residents were required to have evidence of a negative Covid -19 test result and had to agree to self isolate for a period on arrival. They did not use any communal areas and their laundry was kept separately from others.
The registered manager told us the staff team had been meticulous in adhering to the new processes in place. Staff sickness and absence was low and there had been no need to use agency. One member of staff had previously had a second job. Their hours had been increased so they no longer needed to work in two settings thereby minimising the risk of cross infection.
The registered manager had considered the actions they would need to taken in the event of an outbreak. This included zoning areas and identifying dedicated staff to support people who had contracted the infection.
People’s experience of using the service:
• People were happy living at the service. “They [staff] look after me well,” “I like it here, I feel safe” and “They always give me something that I like, they are very good to me here; I don’t think that I would have lasted this long if they hadn’t been so good”
• The registered manager was very visible in the service working alongside staff and providing care and support to people. People told us, “[Registered manager] is very pleasant and friendly and I often see her” and “She’s [Registered manager] always around and in the mornings, she’ll have a chat with us.”
• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
• There were sufficient numbers of suitably qualified staff working at the service. The staff group was stable with many having worked there for years. Staff were happy working at the service and told us they felt the registered manager was approachable and supportive.
• People received their prescribed medicines in a safe manner. Recent medicine audits had highlighted that improvements were needed in handwritten medicine records. We saw this had taken place and the subsequent audit recorded no further concerns in this area.
• The premises were well maintained. There were regular checks of the service to identify any improvements required.
• People had access to good nutritious food. Staff provided support to people with their meals as needed.
• Risks were identified, recorded and monitored. People were supported to live as independently as possible. Any accidents were reported, recorded and audited to help address any patterns or trends and help reduce further events.
• Staff were kind and caring. We observed many positive interactions between staff and people living at the service. Staff respected people’s dignity and privacy.
• People had access to activities. Care staff provided a varied programme of activities which were planned and advertised in advance.
• Care plans were person centred and regularly reviewed to take account of any changes in people’s care and support needs.
• People were able to see their GP and other healthcare professionals as needed.
• The service had a complaints policy which was available to people should they need to raise any concerns. There were no complaints in process at the time of this inspection. People were happy living at the service and told us they had no cause to complain.
Rating at last inspection: At the last inspection the service was rated as Good (report published 23 February 2017)
The service remains Good following this inspection.
Why we inspected: This inspection was bought forward due to information of concern received by the Care Quality Commission. Anonymous allegations had been made around the management of incidents which took place at the service, a lack of maintenance to the building, poor staff management and a lack of respect and dignity provided for people. A concern had been raised by the family of a person living at the service about poor communication between them and the staff when their family members needs had changed. We looked at the risks associated with these concerns. We did not substantiate these concerns at this inspection.
Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
We inspected Garsewednack on 18 January 2017. The inspection was unannounced. The service was last inspected in December 2013 when it was found to be meeting the requirements of the regulations.
People told us they felt safe at the service and with the staff who supported them.
People told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.
Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.
Staff training was delivered to a satisfactory standard, and staff received updates about important skills such as moving and handling at regular intervals. Staff also received training about the needs of people with dementia. However staff had not received any training about the Mental Capacity Act 2005 or Deprivation of Liberty Safeguards.
Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.
People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals.
There were enough staff on duty and people said they received timely support from staff when it was needed. People said call bells were answered promptly and we observed staff being attentive to people’s needs.
Care was provided appropriately and staff were viewed as caring. Comments received included: “I am well looked after here,” “Mum is very pleased with everything,” “No complaints at all…excellent, very friendly and helpful,” and “I would not hesitate to recommend it to anybody.”
The service had some activities organised. These activities included, bingo, hand massage, ‘games afternoon’s’ Karaoke, and quizzes. However people who used the service said they would like more variety of activities and the opportunity to go out on trips. As a consequence we have recommended the registered persons review the current activity programme.
Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).
Most people were happy with their meals. Everyone said they always had enough to eat and drink. People said they were provided with a choice of meals. People said they received enough support when they needed help with eating or drinking.
People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.
People felt the service was well managed. There were suitable systems in place to measure, and as necessary improve, the quality of the service.