Background to this inspection
Updated
13 April 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was completed by an inspector, a medicines inspector, and an Ex pert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
London and Manchester Healthcare Limited, Gainsborough House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. London and Manchester Healthcare Limited, Gainsborough House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people living in the home and 6 visitors. We also spoke with 3 members of staff, the registered manager and quality and compliance manager. We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 4 files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. After the inspection we continued to seek clarification from the provider to validate evidence found and the provider was able to provide evidence of actions taken following the inspection.
Updated
13 April 2023
About the service
London and Manchester Healthcare Limited, Gainsborough House is a residential care home providing personal and nursing care to up to 72 people. At the time of our inspection there were 68 people using the service across three separate wings, each of which has separate adapted facilities.
People’s experience of using this service and what we found
The service had addressed some of the issues from the last inspection, and we found medicines were managed safely across the home, however we made some recommendations about medicines management.
There were a range of effective provider and manager quality assurance processes in place, the provider had learnt lessons from the previous inspection and improved services.
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.
Risk assessments held appropriate information. Care plans and risk assessments were person centred and detailed how people wished and needed to be cared for; these were regularly reviewed and updated as required. We saw evidence of how the registered manager and staff ensured people beliefs, choices and rights were respected. This was supported in feedback we received from people and their relatives.
The recruitment of staff was safe and there were enough staff on duty on the day of inspection to meet people's needs. Risks to people's health and safety had been assessed and mitigated and equipment had been serviced and maintained. Accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence.
We observed support being provided in the home and saw this was done in a caring, responsive, and patient manner. We saw people were comfortable in the presence of staff and positive relationships had developed between people receiving support and staff. A visitor told us “There are always plenty of staff about and they always seem patient and kind with the residents. There seems to be more permanent staff about lately, they do use some agency staff, but they also seem genuinely nice. The home is always spotless with no nasty odours. I have no concerns about any other residents or the way anyone is treated. There is always a very pleasant friendly atmosphere when I visit.”
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 03 December 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service. 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. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.