Background to this inspection
Updated
16 January 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 carried out by two inspectors 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
Guys Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (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.
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, including information from the provider about important events that had taken place at the service, which they are required to send us. We sought feedback from the local authority and Healthwatch Lancashire. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections and we used this to plan our inspection.
During the inspection
We spoke with nine people who lived at the home, three relatives, the registered manager and area manager. We also spoke with seven members of staff and the cook. We observed care practices and how staff interacted with people in their care. This helped us understand the experience of people supported by the service.
We looked at care records of two people and arrangements for meal provision. We also looked at records relating to the management of the home, recruitment of a staff member and medicines records of two people. We reviewed the services staffing levels and walked around the building to ensure it was clean, hygienic and a safe place for people to live.
After the inspection
We continued to communicate with the provider to corroborate our findings and further information was sent by the provider in response to the feedback provided during the inspection visit.
Updated
16 January 2020
About The service
Guys Court Nursing Home provides residential and nursing care for up to 37 people. Situated in Fleetwood, the home has a car park and disabled access to the building. It is a three-storey purpose built home, with a passenger lift to all floors. At the time of the inspection visit there were 27 people who lived at the home.
People’s experience of using this service and what we found
There were issues around safe staffing levels. Comments from people and observations found shortfalls in the level of staff to support people. Although medication administration was satisfactory we found an issue with one person not receiving their medication in a timely manner. People we spoke with told us they felt safe from the risk of abuse. The registered manager recorded and audited any incidents and accidents and learnt from them. Staff continued to be recruited safely Infection control systems and audits continued to ensure a clean environment and reduce any risks.
We have made recommendations about medication and staffing levels, which can be found in the ‘safe’ section of this report.
The service did not have clear support from the provider and changes had affected the running of the home staff were not supported consistently. The registered manager worked in partnership with a variety of agencies to ensure people’s health and social needs were met. The registered manager had improved methods to assess and monitor the quality of the service on a regular basis.
We have made a recommendation about the service and workforce management, which can be found in the ‘well led’ section of this report.
The registered manager ensured staff received an effective induction and training programme that was continually updated. People spoke positively about the quality of meals and praised the cooks for the choices available. People received support with their healthcare needs. 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.
People we spoke with and our observations confirmed staff were kind, caring, and treated people with respect. Information about local advocacy services was available, to ensure people could access support to express their views if required.
Activities were varied, and people told us there were trips and entertainment regularly provided. Activity co-ordinators were employed to support people and their interests. People’s communication needs had been assessed and where support was required this had been given. People knew how they could raise concerns about the service and a complaints procedure was in place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was requires improvement (published 11 October 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.