Garland House

We found the following examples of good practice.

The service supported people to maintain safe contact with friends and family. People were supported to use the telephone and internet, and visits were facilitated using the garden and indoors with the use of protective screens.

Plans were in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment (PPE) that were readily available at stations throughout the service.

The provider had measures in place to prevent visitors from catching and spreading infections. Visitors were asked health screening questions and to sanitise their hands on arrival. Temperature checks and lateral flow tests were carried out and once a negative result was received staff facilitated the visit.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19. The building was clean and free from clutter and high touch areas were subject to enhanced cleaning.

Staff ensured people’s welfare had been maintained by facilitating socially distanced activities, such as creative sessions and sharing stories to stimulate discussions. People self-isolating received one to one support with activities.

Garland House is a residential care home providing personal care to 18 people aged 65 and over at the time of the inspection. The service can support up to 20 people.

People’s experience of using this service and what we found

We found improvements were required to the way in which people’s medicines were managed because storage area temperatures were not monitored, and stocks of people’s medicines could not always be accurately checked to ensure they were correct. Improvements were also required to the provider’s systems for monitoring service quality and safety because medicines audits were not robust in identifying these issues.

We have made a recommendation about the use of nationally recognised assessment tools when assessing people’s needs.

People told us they were happy living at the home and that they received high quality support. They were protected from the risk of abuse because staff were aware of the action to take if they suspected someone had been abused. Risks to people had been assessed and staff followed the guidance in people’s care plans in order to safely manage identified risks. Staff also worked in ways that minimised the risk of the spread of infection.

The home had enough staff working on each shift to meet people’s needs. The provider followed safe recruitment practices. Staff knew to report incidents or accidents that occurred and the registered manager reviewed incident and accident records for learning, to reduce the risk of repeat occurrence. Staff were supported in their roles through an induction, training and regular supervision. The home had been adapted to meet people’s needs.

People were supported to maintain a balanced diet and told us they enjoyed the food on offer at the home. They were able to access to a range of healthcare services where needed and staff worked to ensure they received consistent support when moving between different services. Staff sought people’s consent when offering them support. 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.

Staff treated people with care and compassion. They respected people’s privacy and treated them with dignity. People were able to express their views and were involved in making decisions about the support they received. They had also been involved in the planning of their care and told us that staff supported them in line with their expressed preferences. The provider arranged activities for people to take part in which they told us they enjoyed. People knew how to complain and expressed confidence that any issues they raised would be addressed.

Staff spoke positively about the way they worked together and told us they were well supported by the registered manager. The registered manager demonstrated a good understanding of the responsibility of their role. They sought feedback from people and their relatives on the service they provided, and this feedback had been positive.

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 good (report published 16 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people. There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role.

Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions. Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People were supported to have choice and their independence was promoted by staff who understood the needs of older people and of those living with dementia. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People were very complimentary about the meals and quality of food provided. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records help staff deliver care that met people’s individual needs. The activities provided were suitable for older people and people living with dementia.

The provider and the management team were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and care.

Further information is in the detailed findings below.

All the people we spoke to expressed their satisfaction with the service and the level of support provided, and did not raise any concerns about the quality of care. They also said that they would go the manager or staff if they needed to raise a concern and would feel comfortable in doing so.

Many comments we received were complimentary of the service. One person said "the care is really extraordinary, they think of everything" and another stated that they were "well looked after" and "treated with respect". Another person commented how the staff "get to know people and what they like".