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Inspection Summary


Overall summary & rating

Good

Updated 9 January 2018

This unannounced comprehensive inspection took place on 18 December 2017.

At the previous inspection we found breaches of regulation in relation to; the safe administration of medicines, governance, safe recruitment and staff support. As part of this inspection we checked to see if the necessary improvements had been made and sustained. The service was now meeting regulatory requirements.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; Safe, Effective and Well-led to at least good. We found that improvements had been made in accordance with the action plan in each of the key questions.

Garswood 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.

Garswood is located in Southport close to public transport links and Birkdale village. Accommodation is arranged over four floors with lift access to each floor. The home is registered to accommodate 39 people and includes a dedicated unit (Hazelwood) to accommodate seven people who are living with dementia. At the time of the inspection 22 people were living in the main building with a further seven in Hazelwood.

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 observed a member of staff while they administered some medicines and checked records, storage arrangements, stocks and audits. The medication policy was comprehensive and audits had been effective in identifying errors. The provider was no longer in breach of regulation 12 with regards to the safe administration of medicines.

We checked four recruitment files and found that they reflected safe recruitment practice. Each file contained an application form with a detailed employment history, photographic identification, references and evidence of a DBS check. The provider was no longer in breach of regulation 19 regarding the recruitment of fit and proper persons.

The majority of supervision and appraisals had been completed in accordance with the provider’s schedule. Where meetings had not taken place the reason was recorded and alternative dates had been entered onto an electronic record. Staff told us that they were well supported by the management team and could request additional support through informal or formal supervision as required. The provider was no longer in breach of regulation 18 regarding staff support.

During this inspection we saw evidence of regular audits being conducted and action taken when issues were identified. Audits looked at a full range of relevant areas such as; health and safety, MCA/DoLS status, medicines, welfare, maintenance and activities. The provider was no longer in breach of regulation 17 regarding quality assurance processes.

The staff that we spoke with were able to explain how they helped to keep people safe and safeguard them from potential abuse. Information about safeguarding was clearly displayed within Garswood and the staff we spoke with were able to explain their responsibilities to report concerns both internally and externally (whistleblowing) if required. Individual risk was appropriately assessed and reviewed to ensure that people were kept safe without unnecessarily restricting their independence.

Garswood had a robust approach to the recording and monitoring of incidents and accidents. The records that we saw were detailed and showed evidence of review and analysis by the registered manager.

The home was operating in accordance with the principles of the M

Inspection areas

Safe

Good

Updated 9 January 2018

The service was safe.

Robust systems were in place to protect people from abuse and neglect.

Risk was appropriately assessed and subject to regular review.

Medicines were safely administered in accordance with best-practice guidance.

Effective

Good

Updated 9 January 2018

The service was effective.

Staff were trained and supported by the service to ensure that they had the right skills and knowledge.

The service operated in accordance with the principles of the Mental Capacity Act 2005.

People were supported to maintain good health in conjunction with a range of community healthcare services.

Caring

Good

Updated 9 January 2018

The service was caring.

People were treated with respect and kindness by staff.

People were encouraged to express their views and were actively involved in decisions about their care.

Staff supported people to maintain their privacy and dignity in all aspects of care.

Responsive

Good

Updated 9 January 2018

The service was responsive.

Care records were developed with the involvement of people and their relatives and subject to regular review.

The service received a very low level of complaints.

People were supported at the end of their lives to have a pain-free, dignified death in accordance with their wishes.

Well-led

Good

Updated 9 January 2018

The service was well-led.

The service had a clear management structure and staff understood their roles and responsibilities.

People were consulted and communicated with through a range of appropriate means.

The service demonstrated a commitment to continuous improvement and worked effectively with other agencies.