Archived: Goodwood Orchard Residential Care Home

At the last comprehensive inspection of this service in 7 and 8 December 2016 we rated the service as ‘requires improvements’. We found breaches of the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to the premises, lack of person centred care and support provided and lack of good governance. We issued requirements notices and a warning notice in relation to good governance.

An unannounced focused inspection of Goodwood Orchard Residential Care Home took place on 5 April 2017 to check that improvements to meet the legal requirement with regards to good governance were being met. We found some improvements had been made. We were unable to revise the rating because further action was needed to ensure those improvements were fully implemented and sustained.

At this inspection, we found the service had made the required improvements and we revised the overall rating to good.

Goodwood Orchard Residential Care Home 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.

People were supported by staff who knew how to keep people safe, recognise abuse and how to respond to concerns. Risks associated to people’s physical and mental health had been assessed. Staff understood people’s care and support needs and their care plans provided clear guidance to follow. People were involved in the development of care plans to ensure care was personalised, and promoted their wellbeing and independence. Care plans were regularly monitored and reviewed.

People received their medicines safely. People’s dietary needs were met. People had access to a range of healthcare services and attended routine health checks.

People lived in a clean and well maintained environment.

People’s safety was protected because staff were recruited through safe recruitment practices. We found there were sufficient numbers of staff to provide care and support when people needed it. Staff received an appropriate induction, training and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood their role, and policies and systems in the service supported this practice.

People’s privacy and dignity was respected. Staff’s approach was caring and they knew people well. People maintained contact with family and friends. People joined in social activities that were of interest to them and observed their faith.

People’s views about the quality of the service were sought individually and through meetings to ensure they were satisfied with the service. People and their relatives felt confident to raise concerns with the registered manager. A complaint process was available and advocacy support was made available to people.

The registered manager and deputy manager collectively provided clear leadership. The provider was meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.

We carried out a focused inspection of this service on 5 April 2017 which was unannounced. We checked that they had followed their plan and to confirm that they now met the legal requirement. This report only covers our findings in relation to ‘Well-Led’. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Goodwood Orchard Residential Care Home on our website at www.cqc.org.uk

Goodwood Orchard Residential Care Home is a care home that provides residential care for up to 18 people and cares for older people. At the time of our inspection there were 15 people using the service.

A registered manager was 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.

At this inspection we found the provider had made improvements to the way they managed the service. Further action was needed to ensure those improvements were sustained.

The registered manager had updated their knowledge in relation their role, responsibilities to manage and provide a quality care service.

People’s care plans had been reviewed and amended where people’s needs had changed. Care plans provided staff with clear guidance about the support people required. People and their relatives, were involved in the development and review of their care plans.

The registered manager had updated the policies and procedures. Records showed staff’s training was up to date and that they were supported in their role through supervisions and meetings.

We found improvements were made to the premises and equipment used in the delivery of care were stored safely. Repairs and decoration had been completed to improve the living environment. All areas were clean and monitored to ensure people lived in a clean and safe environment.

Improvements were made to ensure systems were in place and used effectively to monitor the quality of care provided through regular checks and audits. Records showed the registered manager and the deputy manager addressed issues identified through the audits and feedback from people who used the service, their relatives, and staff in order to develop the service.

Goodwood Orchard Residential Care Home is a care home that provides residential care for up to 18 people and cares for older people and those living with dementia. At the time of our inspection there were 16 people in residence.

A registered manager was 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.

We inspected the service in January 2016 and found the provider had made improvements to the quality of service but further action was needed to ensure the improvements had been sustained.

At this inspection we found there was a lack of leadership and management of the service. The registered manager had not kept their knowledge up to date with regards to their legal responsibilities as a registered manager to ensure the service was safe.

The system to monitor and assess the quality of the service remained fragmented and was not effective in identifying some of the shortfalls we found during this inspection. Records relating to people, staff and the management of the service were not always kept up to date, accurate or easily accessible.

The system to monitor and assess people’s ongoing needs was not effective. Care plans and risk assessments were not always reviewed in line with the provider’s policy. The guidance in the care plans for staff to follow was not always updated. Staff relied on the information shared between staff teams during handover. This meant people were at risk of receiving care and support that did not meet their needs.

We found people’s health, safety and wellbeing were put at risk because the provider and registered manager had not maintained a safe environment for people to live in. Improvements were needed with regards to the hygiene and cleanliness to prevent the risk of spreading infection. Repairs were needed to make safe some parts of the building. People were not able to access all bathrooms and toilets. Equipment was not stored safely.

Staff told us they received training and were supported and supervised by the deputy manager on a day to day basis to ensure people received effective care. We found no record of staff’s induction training completed. The deputy manager’s induction training was not planned. Staff’s training records were inaccurate or up to date. The system to monitor staff’s knowledge, skills and competence was fragmented. Staff were not supported to develop their confidence, knowledge and personal development.

People’s medicines were administered in a safe way by trained staff. To ensure medicines were kept secure at all times staff should keep the medicine trolley locked when left unattended.

People’s safety was promoted because the staff were trained in safeguarding adults, understood their role to report concerns or if they suspected that someone was at risk of harm. The provider had made referrals to the safeguarding authority and notified us when people’s safety was of concern.

People’s safety was promoted through the employment of staff. Whilst the provider continued to recruit staff agency staff had been used to ensure there were enough staff to provide the support people required.

People’s needs were assessed and their safety and wellbeing was promoted through risks being managed. Staff were provided with information to support people and equipment was used to enable people to move around safely.

People spoke positively about the choice of meals provided that met their dietary needs. People had access to health support and referrals were made to relevant health care professionals where there were concerns about people’s health.

The deputy manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and supported people to make informed decisions about their care. Records showed people and where appropriate their relatives were involved in making informed decisions about all aspects of their care.

People were involved and made decisions about their care and support needs. People told us that staff were kind, caring and respectful of their privacy and dignity. People told us that the staff were responsive to their needs and requests for assistance.

People maintained contact with family and friends. They took part in social activities of interest to them and activities organised by the staff.

We found three 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 this report.

We undertook this focused inspection of this service on 5 January 2016, which was unannounced. The focus of the inspection was to check that they had followed their plan of action and to confirm that they now met legal requirements. This report only covers our findings in relation to the requirement and information gathered as part of the inspection. You can read the report from our last comprehensive inspection, by selecting ‘all reports’ link for Goodwood Orchard Residential Care Home on our website at www.cqc.org.uk

Goodwood Orchard Residential Care Home is a care home that provides residential for up to 18 people and cares for older people and those living with dementia. At the time of our inspection there were 17 people in residence.

A registered manager was 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.

We found that the provider had taken action and made the required improvement to meet the legal requirement in relation to the breaches.

People were involved in making decisions about their care and in the development of their plans of care when they first started to use the service. Care plans were up to date to reflect people’s current needs and how staff should support them. People and in some instances their relatives and health care professionals were involved or consulted with regards to reviewing people’s needs to ensure staff provided the care that helped to maintain people’s safety and wellbeing.

People were encouraged to take part in planned activities and how people wished to spend their day was respected.

The provider’s quality governance and assurance systems were used effectively to ensure people’s health, safety and welfare. Regular internal audits were carried out and information gathered from those including views from people who used the service and staff were used to continually develop the service.

Below is a summary of what we found. The summary is based on our observations during the inspection and what we learned when we spoke with people using the service. We also spoke with and observed the staff group and obtained information from the records we looked at.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People had been cared for in an environment that was safe, equipment at the home had been well maintained and serviced regularly. People told us their care and support needs are met safely and reliably because there were enough staff on duty to meet the needs of people living at the home. The manager and/or the deputy manager were available in case of emergencies.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Staff training records showed that relevant staff had been trained in Mental Capacity Act 2005 and DoLS. We spoke with the registered manager and deputy manager and both had a good understanding of when a DoLS application should be made, and in how to submit one.

People told us they are satisfied with how their medicines are given to them. One person said, 'I know exactly what my tablets are for and when I should take them.' There were suitable arrangements in place to store medicines safely. Staff were trained and understood people's individual medicine requirements. Staff followed the medication administration procedure correctly and completed the medication records accurately.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations that staff had a good understanding of people's care and support needs and that they knew them well.

People were given information about the advocacy service when they moved to the home. This meant that people could access additional support and/or advice when required. Staff had received ongoing training and development to help ensure the needs of people living at the home could be met reliably.

Is the service caring?

People were supported by kind and attentive staff. We saw that both the deputy manager and care staff showed patience and gave encouragement when supporting people. We saw staff supporting people to do things at their own pace and were not rushed. We saw the deputy manager when administering medication to people, they explained to them what medication they were taking and why. We observed staff supporting people to walk around the home, giving clear guidance and encouragement to walk in a safe manner using walking aids. One person told us 'I am very happy here, this is now my home and I have no complaints.' A visiting relative also had high praise about the care their family member had received and told us, 'This is one of the best homes around. The staff really do care for people and make every effort to make it as homely as possible.'

Is this service responsive?

People's needs had been assessed before they moved into the home. Records confirmed people's preferences, interests and expectations had been recorded and care and support had been provided in accordance with people's wishes. We found people had access to health care professionals such as the doctor and/or the community nurse to meet their specific health needs. People had access to activities and were supported to maintain relationship with their relatives and friends. One person told us that staff supported them to go shopping and do activities that were of interest to them. Another person said, 'I like to go out every week. This weekend I'm going to stay with family and the deputy has made sure my tablets and everything is organised.'

Is this service well led?

The provider's quality assurance processes were in place, which included surveys to gather the views of people who lived at the home along with their relatives. Meeting were held regularly for people living at the home and their relatives where they could share their views and experiences. These meeting helped to ensure people were given information about any changes to the home and to discuss general issues. We found people's views were listened to and acted upon. The provider had a complaints policy and procedure that was effectively used for the benefit of people living at the home and for making continued improvement to the quality of service provided.

We looked at records for three people who used the service. The care records had a care and support plan in place which identified any risks and how these could be managed.

We found that staff supported people appropriately and spoke to them in a friendly and respectful manner. Staff understood peoples' needs and preferences and respected their choices.

Staff were trained and supported and delivered care which met peoples' needs. Staff we spoke with had a good understanding of the different types of abuse and could explain what they would do if they suspected someone was being abused. They knew who they would report this to both within the service and to external agencies.

We found that the provider had adequate quality assurance processes to ensure the comfort and safety of the people they cared for were maintained.