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Archived: Goodwood Orchard Residential Care Home Good

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Reports


Inspection carried out on 3 August 2017

During a routine inspection

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.

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.

Inspection carried out on 5 April 2017

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 7 and 8 December 2016. A breach of the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was found.

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.

Inspection carried out on 7 December 2016

During a routine inspection

This inspection took place on 7 December 2016 and was unannounced. We returned on the 8 December 2016 announced to complete the inspection.

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

Inspection carried out on 5 January 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 14 and 15 September 2015. We found two breaches of legal requirements. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. Those related to how people’s assessed needs were used to develop care plans that reflected how staff supported people to ensure the care and support provided was consistent and person centred and implementing a quality assurance system to assessment and monitor the service provided.

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.

Inspection carried out on 14 and 15 September 2015

During a routine inspection

This inspection took place on 14 September 2015 and was unannounced. We returned on 15 September 2015 announced.

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. The accommodation is over two floors, accessible by using the lift and stairs. 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.

People told us they felt safe at the service and with the staff that looked after them. Staff had a good understanding of safeguarding (protecting people from abuse) and knew how to keep people safe.

People’s care needs were assessed including risks to their health and safety when they first started to use the service. Care plans were developed using the information from the assessments which included the measures to meet people’s care needs and help to keep them safe. Not all the care plans had been changed to the new care plan format which had more information and guidance for staff to ensure people’s care and support needs were met.

We found risks to people’s health and wellbeing were not monitored or reviewed regularly. Records showed both the care plans and risk assessments had not been reviewed since May 2015 and were not reflective of people’s current needs. That meant people may receive unsafe or inappropriate care. People were not always involved in the review of their care to ensure they continued to be satisfied with the care provided.

People received their medicines at the right time. Regular monitoring was needed to ensure safe temperatures were maintained for medicines that needed to be refrigerated. Further action was needed to ensure medicine policy and procedure that staff referred to was up to date.

People lived in an environment that was kept clean and equipment that was regularly serviced and maintained.

Staff were recruited in accordance with the provider’s recruitment procedures, which helped to ensure suitable staff, were employed to look after people.

Staff received an induction when they commenced work and on-going training to support people safely. Staff found the dementia awareness training valuable because it had helped them to adapt their practices to ensure they supported people living with dementia appropriately. Staff used equipment correctly and safely. Staff were supported through meetings, supervisions and appraisals.

People were protected under the Mental Capacity Act and Deprivation of Liberty Safeguards. The registered manager and staff understood their role in supporting people to maintain control and make decisions which affected their daily lives. Referrals, where appropriate, had been made to supervisory bodies where people did not have capacity to make decisions or restrictions were placed upon them.

People were provided with a choice of meals 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 attitude of the management and staff showed they were caring, friendly and talked about their work and were well informed about those using the service. Staff were committed to providing the best possible care for all those who used the service.

There were limited planned activities which people could take part in. People were supported to observe their faith. People received visitors throughout the day and evenings and could have meals with them. Staff were knowledgeable of people’s life history and things that were of interest to them. Staff organised activities on an ad hoc basis if people were interested. During our visit we saw staff spent time talking to people about topics that were of interest to them.

People were confident to raise any issues, concerns or to make complaints, which would be listened to and acted on appropriately.

The provider did not have a formal quality assurance or governance system in place that helped them to ensure a quality service was provided. There were limited audits carried out but those were not done consistently. There was no evidence to demonstrate how the provider reviewed or monitored the service to ensure any shortfalls identified had been addressed. The provider did not regularly seek the views from people who used the service or their family, about the service, the care and treatment provided and their involvement in how to develop the service. That showed the provider and the registered manager could not assure themselves, the people who used the service, their relatives and staff that the service was well managed and took steps to provide a quality service.

We found 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.

Inspection carried out on 2 April 2014

During a routine inspection

We recently undertook an inspection visit to Goodwood Orchard Residential Care Home on a planned inspection. We looked at the following areas to ascertain the findings of this report and answer our five questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

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.

Inspection carried out on 30 May 2013

During a routine inspection

We spoke with four people who used the service and with three relatives who were visiting. All the people we spoke with were happy with the service. One person who lived in the home told us they were “well looked after. The food is good and there are fresh vegetables. I can choose when I get up and where I sit”. Another person told us that the staff “are very nice and they look after me better than I can look after myself”

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.

Inspection carried out on 11 May 2012

During an inspection in response to concerns

When we visited the home we spoke to five of the people who use the service and four staff. We did not get the opportunity to speak to any relatives, however we did see the results of a relatives survey that was carried out this year at Goodwood Orchard.

The people who use the service told us they made choices about their care, activities, and meals. One person said, “I like to get to bed late, at about 10pm. I just tell the staff when I’m ready.” Another person told us, “I can have a bath or a shower but I prefer a shower. I say when I want one and the staff sort it out.”

On the day we inspected people were having fish and chips from the local chip shop for their lunch, followed by ice creams. The manager told us this was their choice. One of the people who uses the service said, “I’m pleased with the food – there’s a good variety and we can have what we want.”

People told us they thought the care the home provided was good. One person said, “I couldn’t be happier than I am here. Everything is done for me and I’m helped.” Another person commented, “The staff are always on the phone chasing up the doctors. It’s nice to be able to leave it to them and not have to do it myself.” However records needed improving to help ensure people's needs were identified and met.

People said they felt safe at Goodwood Orchard and knew who to speak to if they had any concerns. One person told us, “I’d tell the manager if there was anything wrong.” Another commented, “If there was anything wrong of course I’d speak out. The manager wants us to.”

People told us they liked the staff and found them caring and approachable. One person told us, “The staff are marvellous. They are all so friendly, even the cook waves to me and says hello every day.” Another commented, “I like it here because the staff are lovely.”

We observed there were enough staff on duty to meet people’s needs and the people who use the service agreed with this. One person said, “If I’m in my room and I need the staff, day or night, I ring the bell and they come quickly.

People said they thought the home was well-run and staff and management were approachable and easy to talk to. One person told us, “I can speak to the manager any time I want to and tell her what I think about the home.” Another person commented, “The manager wants us to have the best of everything.”

The home carries out an annual survey of the views of the people who use the service and their relatives/representative. One person who had completed the survey said they thought it was a good idea. They told us, “I filled in the survey on my own and gave it to the staff. I said I was happy with everything here, but if I wasn’t I would have said.”

Reports under our old system of regulation (including those from before CQC was created)