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Giltbrook Care Home Requires improvement

We are carrying out a review of quality at Giltbrook Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 December 2018

This comprehensive inspection took place on 12, 16 and 19 October 2018; the first day of inspection was unannounced.

Giltbrook Care Home is a 'care home'. People in care homes receive accommodation and nursing or 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. The home provides accommodation and personal and nursing care for up to 40 older people, some of whom are living with dementia. The premises are on two floors with a passenger lift for access. The service has a range of communal areas and a secluded garden. There were 14 people using the service at the time of our inspection.

This inspection was planned to follow up on our previous inspection of 31 January and 1 February 2018 when the service was placed in special measures. We had also completed a focused responsive inspection on 28 March 2018 that was completed in response to concerns with recruitment practices.

At our previous inspection on 31 January and 1 February 2018, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for Regulations 12 and 17. These related to safe care and treatment, management of risks and governance. In addition, we completed a responsive focused inspection on 28 March 2018 and found a breach of Regulation 19; this was because evidence that all the required checks to show staff were suitable to work at the service were not in place.

This service has been in Special Measures following our inspection on 31 January and 1 February 2018. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and it is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. Some improvements were still required and we found a breach of regulation 12 relating to the ordering and supply of medicines.

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.

The system operated for the supply and ordering of people's medicines was not always effective.

Systems and process designed to identify shortfalls in the service had not always been effective as they had not enabled the registered manager to identify some medicines had been out of stock.

Medicines were stored and disposed of safely.

There were sufficient numbers of staff deployed to meet people's needs.

Staff working at the service had been subject to pre-employment checks. Pre-employment checks help the provider decide whether staff are suitable to work at the service.

People and their families felt the care was delivered safely at Giltbrook Care Homes. Staff had an understanding of how to keep people safe and how to report any concerns; this had been reinforced through staff training.

Actions had been taken to identify and manage risks to people from any health associated conditions. Actions had been taken on most risks in the environment. The registered manager took action to further risk assess some radiators during our inspection. Actions were taken from when things went wrong and accidents and incidents were analysed and steps taken to help prevent future occurrence.

Steps had been taken to help protect people from the risks associated with infections. Staff understood and followed infection prevention and control measures.

People's needs were assessed and this helped staff provide care to meet their needs. This was reinforced as staff ha

Inspection areas

Safe

Requires improvement

Updated 11 December 2018

The service was not consistently safe.

The ordering and supply of medicines was not always effective. Other risks associated with infection prevention and control and risks associated with people's care needs were identified and managed. Sufficient numbers of staff were deployed. People felt safe, checks were made on staffs’ suitability for the role and staff were trained in safeguarding people.

Effective

Good

Updated 11 December 2018

The service was effective.

People were treated fairly and the principles of the MCA were followed. Staff received training in areas relevant to people’s care needs. People received sufficient nutrition and fluids and their health needs were assessed. People had access to other healthcare professionals. The premises were suitable for people and met people’s needs.

Caring

Good

Updated 11 December 2018

The service was caring.

Staff were caring and kind. Staff respected people’s privacy and dignity and promoted their independence. Relatives and friends were free to visit. People were involved in decisions about their care and support.

Responsive

Good

Updated 11 December 2018

The service was responsive.

People enjoyed activities and a range of resources was available for people living with dementia. People and relatives were listened to and their feedback was used to improve the service. Systems were in place to manage and respond to complaints. The Accessible Information Standards had been met. Care and support was provided to people when they reached the end of their lives.

Well-led

Requires improvement

Updated 11 December 2018

The service was not consistently well led.

Some systems to reduce risks around medicines were not fully in place. Some potential risks required further risk assessment and this was completed. Other systems to monitor the quality and safety of services were in place. A registered manager was in place and they understood their responsibilities. The service worked in partnership with other agencies. People, their relatives and staff were involved in developing the service.