We carried out a review of the data available to us about Gate Lodge 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 Gate Lodge, you can give feedback on this service.
Gate Lodge is a residential care home providing personal or nursing care to up to 19 adults. The service provides support for older adults living with dementia. Gate Lodge is an adapted building in a residential area of Purley. The home had a lift to assist people in accessing the upper floor of the home. There was an accessible garden to an outside area with seating. At the time of our inspection there were 17 people living at the service.
People's experience of using this service and what we found
People were supported to have maximum choice and control over 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.
People were kept safe. Staff knew how to raise safeguarding concerns and how to report them appropriately. Risks to people were identified as part of the assessment and care planning procedure. Risk management strategies were in place to assist staff to manage these risks and to identify triggers for behaviours that may challenge, for people they were supporting.
There were sufficient numbers of staff to meet people's needs.
People received their medicines in a safe manner. Staff received appropriate training and medicine competencies were assessed to ensure staff followed safe guidance.
Staff received a wide range of training to ensure they had the skills and knowledge to support people safely. Staff told us they also received regular formal and informal support in their supervision with the manager.
People's dietary needs were being met, and they had access to healthcare services where needed.
People were supported by staff in a kind and caring way. Staff knew the people well and care records which were well maintained and easy to access, detailed people's preferences, likes and dislikes. People had access to social activities that met their interests and needs.
A complaints procedure was available and displayed to enable people to access it if they or their relatives had a need to do so.
People received personalised care and support to meet their needs and wishes.
People using the service, relatives and staff were given the opportunity to provide feedback on the service. Regular comprehensive auditing took place to ensure the quality of the service was maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection and update
The last rating for the service was good [published February 2020].
Why we inspected
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information we may inspect sooner.
People’s experience of using this service and what we found
The environment was clean and fresh throughout the home. A new cleaning regime had been introduced since the last inspection. Health and safety issues were addressed with window restrictors installed and communal areas and people’s individual bedrooms newly decorated.
Staff received training in infection control and food hygiene. This has helped to prevent the spread of infection to people.
People said they felt safe living in this home and that staff were kind to them. Relatives confirmed this.
Staff received training in safeguarding adults and the provider followed clear safeguarding procedures that helped to protect people from harm.
Risks to people, including those associated with their healthcare needs, were assessed and managed appropriately to help minimise them.
Whistleblowing procedures were in place and displayed on notice boards for all to see. Staff told us they were confident any concerns they reported would be dealt with appropriately.
Equipment in the home such as the lift was well maintained with regular servicing arrangements in place.
There were sufficient staff to meet people's needs and safe recruitment practices were in place.
People’s medicines were stored, administered, recorded and audited appropriately. The provider had appropriate policies and procedures in place to support people safely with their medicines as prescribed.
Comprehensive needs assessments were carried out and there was sufficient detail and personalisation in the care plan to ensure the person's individual needs were met.
The registered manager and staff had relevant health and social care qualifications and completed training to ensure they were able to meet people’s needs effectively. Support was provided appropriately for staff with regards to their professional roles.
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 procedures in the service supported this practice.
Records showed people were supported to have their health needs met, with access to health professionals as and when required.
People told us the relationship between themselves and the staff team was good. They said their privacy and dignity was respected. They also said they were able to express their views and preferences and staff responded appropriately.
There were systems in place to ensure concerns and complaints were responded to in an appropriate way.
Good quality assurance processes were in place that monitored a wide scope of practice and procedure by staff, identified shortfalls and drove improvements. People, relatives and staff were encouraged to share their views about care and support at the service. The provider worked collaboratively with other agencies and organisations to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was requires improvement (published 21 December 2018) and the provider was in breach of one regulation. 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 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.
Gate Lodge is a care home. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Gate Lodge is located in a quiet residential road in Purley close to good transport links. Gate Lodge provides accommodation and personal care for up to 21 people. At the time of our inspection 18 people were living in the home.
There was a registered manager in post. 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.
Staff demonstrated a good understanding of safeguarding and whistleblowing procedures and knew how to report concerns. Incidents and accidents were recorded and the records showed that actions were taken to minimise the risk of recurrence.
Improvements were required to ensure that people were protected from the risk and spread of infection. People received their medicines as prescribed. However, the arrangements in place for storage of people’s medicines were not always safe.
We were concerned that there were insufficient staff at mealtimes and at night particularly in the event of an emergency. Staff performance was effectively monitored. Staff received supervision and training to ensure they had the skills to meet people’s needs.
The premises were not adequately maintained to ensure people's safety. We have made a recommendation that the provider seeks guidance on good practice in meeting the needs of people living with dementia.
People’s dietary requirements and preferences were recorded and people were provided with choices at mealtimes. People had a sufficient amount to eat and drink. Staff were kind and caring. We found people were being treated with dignity and respect and people’s privacy was maintained.
Systems were in place for monitoring the quality and safety of the service. However, they were not always as effective as they needed to be and when areas were identified as requiring improvement, the provider did not always take prompt action.
We found a breach of the of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 in relation to the provider's failure to provide safe care and treatment. You can see the action we have asked the provider to take at the back of this report.
At a previous inspection in July 2014 a breach of legal requirements was found relating to the safe management of medicines. We undertook a focused inspection of the service in May 2016 to check that they met legal requirements which they had. We undertook an unannounced inspection to the home on 14 and 19 December 2016. The service met all the standards we inspected it against.
A registered manager was in post and was present during our inspection. 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.
People using the service and their representatives told us they felt safe and well cared for at Gate Lodge. There were clear procedures in place to recognise and respond to abuse and staff understood how to follow these. Medicines were managed safely and people received their medicines on time. Staff had the appropriate training to be able to administer medicines competently. Staffing numbers on each shift were sufficient to help make sure people were kept safe.
Staff were caring and treated people with dignity and respect. They received training and support to help them carry out their role effectively. Staff were familiar with people living in the home and understood people’s needs and preferences for the way they wished their care to be delivered.
People and relatives told us staff were kind, attentive and caring. Staff were very respectful in their interactions and engagement with people. Staff sought permission from people before any care or support was offered and personal care was carried out in the privacy of the person’s room. The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). Staff respected people’s right to make their own decisions and supported them to do so.
Staff supported people to eat and drink in an inclusive way and which enabled the person to have a positive experience at meal time. People were supported to take part in activities and to continue to be part of their community. People were supported to maintain relationships with family and friends who were important to them.
There was a positive culture at Gate Lodge where people using the service, their relatives or friends and staff were included with their views listened to and acted upon.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gate Lodge on our website at www.cqc.org.uk.
We found improvements had been made around the management of medicines and in keeping up to date auditable administration records. There were now appropriate arrangements in place for the storage, administration, recording and disposal of medicines. Medicines kept on behalf of people using the service were being administered correctly with up to date records kept. This meant that the provider could check that people had received their medicines correctly
This inspection took place on 19 and 21 November 2014 and was unannounced.
Gate Lodge is a residential care home that provides accommodation and personal support for up to 21 older people living with dementia. There were 19 people using the service at the time of our inspection.
We last inspected Gate Lodge in April 2013. At that inspection we found the service was meeting all the regulations that we assessed.
There was a registered manager in post at the time of our inspection. 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.
People using the service and their representatives told us they felt safe and well cared for at Gate Lodge. They were encouraged to take part in activities and to continue to be part of their community. People were supported to maintain relationships with family and friends who were important to them.
There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Staffing numbers on each shift were sufficient to help make sure people were kept safe.
Medicines were stored securely and safely. However, safe practice was not always being followed around the management of medicines and in keeping up to date auditable records. You can see what action we told the provider to take at the back of the full version of this report
Staff were caring and treated people using the service with dignity and respect. They received training and support to help them carry out their role effectively.
A positive culture was evident at Gate Lodge where people using the service, their relatives or friends and staff were included with their views listened to and acted upon.
We saw staff treated people who used the service with respect and dignity. We found staff were suitably trained and were familiar with the individual needs, abilities, preferences and daily routines of the people they supported.
The provider also had effective systems in place to ascertain the views of people who used the service and their representatives, as well as routinely assess and monitor the quality of the care and support they received.
The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective).
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
People we spoke told us they were happy with the overall standard of the care and support provided at the care home. They felt the staff that worked at the home always treated people with respect and dignity. Typical comments we received, included, 'staff are very caring and always take their time when helping the people who live at Gate Lodge', 'staff always call people by their preferred names', and 'people are looked after well here'.
Two people we spoke with said they were 'happy' with the food they were offered at Gate Lodge.