Gillibrand Hall Nursing Care Home

Updated 3 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 1 inspector.

Service and service type

Gillibrand Hall Nursing Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gillibrand Hall Nursing Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 residents and 5 relatives. We spoke with 15 members of staff including the registered manager, operations manager, care staff, nursing staff and domestic staff.

We looked at a range of records including 3 care plans, risk assessments and medication records. We looked at policies and procedures, audits of performance, and 3 sets of recruitment records.

Updated 3 December 2022

About the service

Gillibrand Hall Nursing Care Home is a residential care home providing personal and nursing care to 47 people at the time of the inspection. The service can support up to 50 people.

Gillibrand Hall Nursing Care Home is a listed building and care is split over 2 floors. There are large, comfortable communal areas and a good amount of outdoor space.

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

People were at risk as systems to manage medicines were not always effective. The fire service identified actions required to make sure people were protected from the risk of fire, and this was ongoing. We have made a recommendation about fire safety. People were cared for by regular staff that knew them well, however the knowledge of agency staff was not as good. People and their relatives said they felt safe and well cared for and staff said they would recommend the home to others. The home was clean and tidy, and staff learned lessons if things went wrong.

People enjoyed living at the home and there were lots of opportunities for social contact. The home had its own transport to support people to go out and take part in local events regularly.

People were supported by staff that were caring and mindful of dignity, and people told us that staff treated them with respect. People were involved in their care and relatives spoke highly about staff.

Not all areas of governance were embedded, such as in relation to regulatory requirements and we have made a recommendation about this. There was a positive culture in the home and people living at the home and their relatives were positive about their care. The registered manager engaged with people and their relatives well and arranged regular team meetings.

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.

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 (published 19 January 2021).

Why we inspected

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns relating to people’s dignity and respect. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Although we found no evidence during this inspection that people were at risk of harm from this concern, we have found evidence that the provider needs to make improvements. Please see the safe key question of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gillibrand Hall Nursing Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to the safe management of medicines at this inspection. The provider has taken steps to mitigate the risks, which we will review.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.