Background to this inspection
Updated
11 February 2020
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 Care Act 2014.
Inspection team
The inspection was completed by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Freda Gunton Lodge 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of the inspection the registered manager was completing a secondment opportunity in the provider’s head office (also on site) A director from the provider group was taking the opportunity to manage the home. The registered manager was available, if requested, throughout the course of the inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Prior to the inspection we reviewed all available information we held on the service and the provider group, we sought feedback from professional teams involved with the home and reviewed information available in the public domain.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with ten staff, including the registered manager, directors, including the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the deputy, activity coordinator, care staff, maintenance, catering and domestic staff. We spoke with 10 people who lived in the home, seven visiting family members and three other visitors. We also spoke with a visiting health care professional.
We looked at five people’s care plans in detail and others for specific information, we also looked at three staff recruitment files. We looked at other records used to support the day to day management of the home, including medicines records, audits and meeting minutes.
After the inspection
The provider sent us additional information after the inspection to show us how they were moving any concerns forward including actions they had already taken following feedback from the inspection.
Updated
11 February 2020
About the service
Freda Gunton Lodge is a residential care home providing personal care for up to 40 people. The home supports people over 65 and was supporting 39 people at the time of the inspection.
The home shares its large gardens with the provider’s supported living service and head office. Freda Gunton Lodge has a large lounge and dining room to the ground floor and other smaller communal spaces. The home is serviced by a large laundry and kitchen on the ground floor but also has satellite kitchen facilities to the first floor. The upper floor is accessible by two passenger lifts and stairs.
People’s experience of using this service and what we found
People received their medicines when they needed them by trained and competent staff. Physical and social needs were met by enough suitably trained staff who knew people well. Staff ensured risks to the people’s health and wellbeing were mitigated wherever possible. This included fire evacuation procedures which were practiced and equipment which was professionally tested to ensure it was safe to use. The home was very clean and staff had access to all the equipment they needed to reduce the risks of infection.
Consent was routinely acquired from people throughout their day but some more formal consents were missing for the use of monitoring equipment. The provider took immediate action to ensure the appropriate consents were in place. 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. The food was enjoyed by everybody we spoke with and there was a good choice available to meet people’s individual needs. Staff had access to comprehensive training covering each aspect of their work, they were also supported to complete relevant professional qualifications. Referrals were made to professional teams when additional support was required.
People’s opinion was sought around the service they received. One person told us, “Whenever I am asked what it is like living here, I say excellent, they think of anything we could need before we do, so it is all in place.” Choices were available in all aspects of people’s lives, we saw there was no dedicated supper time and people received what they wanted to eat, at a time and place of their choosing.
Comprehensive daily records were kept and handovers from shift to shift shared any changes in people’s circumstances or needs. There was a diary which included details of appointments and visiting professionals and any action required. These records were reviewed daily by all staff, ensuring they were kept informed of people’s changing needs. End of life care was fully embedded with staff taking lead roles to implement the Gold Standards Framework for care of the dying. Staff took pride in the service they delivered and we saw from the thank you cards and compliments received, the support was greatly appreciated by family members. When complaints were received they were responded to and steps were taken to change practice if this was required to meet people’s preferences.
Monitoring tools were used to determine if paperwork was completed correctly, lessons were learnt from concerns and the service was delivered in line with people’s expectations. However, these did not always identify where action was required. The provider's area team were completing audits on the service delivered, this allowed the provider to understand if the service delivered met the aims and objectives of the provider group. Staff all enjoyed working for the provider and at the home. They felt valued, showed pride in the work they did and the positive impact they had on people’s lives in the home.
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 (24 May 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.