Archived: Goldendale House

At the last inspection the service was rated as requires improvement. We found the provider was not meeting all the requirements of the law. The provider had not ensured that people were always safeguarded from abuse and had not ensured that requirements of the law were followed in relation to people’s consent to their care and treatment. We had also not received notifications that the provider is required to send us by law.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to ensure they were meeting the regulations. During this inspection we found that the provider had done what they said they would do and were no longer in breach of the regulations.

Goldendale House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Goldendale House accommodates up to 42 people in one adapted building. At the time of this inspection there were 35 people using the service.

There was a registered manager in post at the time of the 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 were protected from avoidable abuse and harm by trained staff. Risks were assessed, identified and managed appropriately, with guidance for staff on how to mitigate risks. Premises and equipment were managed safely and were kept clean and tidy. Staffing levels were sufficient to meet people's needs and staff had their suitability to work in a care setting checked before they began working with people. Medicines were managed safely. The registered manager had systems in place to learn when things went wrong.

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 support this practice. People were supported by trained staff and received effective care in line with their support needs. Staff received regular supervision and observations of their competency. There was a good choice of food, which people enjoyed and they received support to meet their nutrition and hydration needs. The environment was designed to support people effectively. Healthcare professionals were consulted as needed and people had access to a range of healthcare services.

Staff were kind, caring and compassionate with people. People were supported to express their views and encouraged and supported to make their own choices. People were treated with dignity and respect and their independence was respected and promoted.

Staff understood people and their needs and preferences were assessed and regularly reviewed. Activities were organised by staff and people were supported to participate in activities that were meaningful to them. People's cultural needs were considered as part of the assessment and care planning process. Complaints were managed in line with the provider's policy. Where required people received good support, in line with their wishes at the end of their lives.

A registered manager was in post and was freely available to people, relatives and staff, along with the provider. People, their relatives and staff were involved in the development of the service and they were given opportunities to provide feedback that was acted upon. We found the registered manager and providers had systems in place to check on the quality of the service people received and use this to make improvements.

The service was registered to provide accommodation and personal care for up to 31 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 28 people were using the service.

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.

We had not been informed about some important events which occurred in the home, which is a requirement of registration with us. This was a breach of Regulations 16 and 18 of The Care Quality Commission (Registration) Regulations 2009 (Part 4). You can see what action we told the provider to take at the back of the full version of the report.

People were not consistently protected from avoidable harm and abuse because we saw that potential safeguarding incidents had taken place and concerns had not been reported to the local authority in line with local safeguarding adult’s procedures.

People’s risks were not always suitably assessed and planned for to ensure they received consistent care to keep them and others safe.

People’s oral medicines were managed so that they received them as prescribed. However, there were gaps in the administration records for topical creams so we could not be sure that people were receiving them as prescribed.

There were sufficient staff to meet people’s needs and staff were trained and supported to deliver effective care.

The principles of the Mental Capacity Act (2005) were not consistently followed to ensure that people’s legal and human rights were respected.

People were provided with enough food and drink to maintain a healthy diet. People’s health was monitored and access to healthcare professionals was arranged when required.

People were treated with kindness and compassion and they were happy with the care they received. People were encouraged to make choices about their care and their privacy and dignity was respected.

People’s plans of care were not always sufficiently detailed and up to date so there was a risk they may receive inconsistent care that was not personalised.

People had access to activities that interested them and could spend their time how they chose.

People knew how to complain if they needed to. A complaints procedure was in place and complaints had been dealt with in line with this procedure.

Systems were in place to monitor quality and actions were usually taken to make improvements when required. However, these systems had not identified all of the issues we found during the inspection.

People did not know who the registered was though they knew the providers and the assistant managers and felt they were approachable and visible around the service. There was a positive culture and people and staff felt included in the development of the service.

We identified two breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

During our inspection, everybody received unhurried care and support. Everyone received the same caring response from care staff and were included in the activities and conversations taking place.

People were given a choice of suitable food and drink to meet their nutritional needs. An initial nutritional assessment was completed on admission to the home. This explored people's dietary needs and preferences. Where there were concerns with unexplained weight loss, or poor appetite and fluid intake, care staff would complete daily food and fluid records.

There were appropriate procedures in place to minimise the risk of the spread of infection in the home. The home was kept to a high standard of cleanliness. We spoke with two relatives visiting the home during our inspection. Both confirmed that they always found the home was kept clean. One relative told us, 'The home has impeccable standards of cleanliness and hygiene.'

We found that the general quality and completeness of records relating to the day to day delivery of care needed to improve to reduce the risk of decisions being made on out of date or inaccurate information.

At this inspection, we found that clear standards for recording had been set and were being followed in the home by staff. This ensured that records were fully completed and provided a detailed overview of a person's day and any changes in their care and support needs.