The Care Quality Commission
  • Care Home
  • Care home

Archived: Geel and Hitchen Court

Overall: Requires improvement read more about inspection ratings

Woodlands Road, Aigburth, Liverpool, Merseyside, L17 0AN (0151) 729 0117

Provided and run by:
Nugent Care

All Inspections

6 & 13 November 2014

During an inspection looking at part of the service

Geel and Hitchin Court provides accommodation for up to 28 older people who are living with dementia and require nursing care. The building is single storey and has 28 single bedrooms. There were 24 people in permanent residence and one person on a respite stay at the time of our inspection.

This was an unannounced inspection, carried out over two days on 6 and 13 November 2014. During the inspection we spoke with five people who lived in the home, seven visitors, seven staff and the registered manager of the home. 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 last inspected Geel and Hitchen Court on 8 May 2014. At that inspection we found the service was not meeting two of the essential standards that we inspected. These were in relation to staffing levels and care and welfare of people. We found that these concerns had been addressed however there were still some areas for further improvement. At this inspection we found concerns with the medication administration, the management of complaints and how feedback from people who lived in the home and their relatives was managed.

We found that the service had addressed the specific areas of concern in relation to the number of carers on duty at tea time and purchase of equipment. We saw that additional staff were now on duty during the evening meal and early evening. Although people told us that they felt safe in this home, there were times when there was not enough staff to meet people’s needs in a timely way. This impacted on the support that people were provided with at lunch time as this was disorganised and people did not receive support at the time they needed it.

People told us, and we found, that people living at the home were generally well cared for, especially at the end of their lives. However, we also saw that staff interactions with people when they were not giving care or support could be improved as we observed carers sitting in the lounge when they had provided support and not engaging with the people sitting there. We identified that dementia care and support is an area that requires improvement.

The home used safe systems when new staff were recruited. All new staff completed training before working in the home and staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual and told us they would be confident reporting any concerns to a senior person in the home. However, we also found that one potential safeguarding incident had not been recorded and that not all complaints were dealt with by the manager or recorded as having been referred to senior management at head office.

Communications in the home would benefit from improvement as relatives and visitors told us that they do not feel involved and are unaware of their relative’s on-going care or any changes to their condition or circumstances.

8 May 2014

During an inspection in response to concerns

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. We found that at times there were not enough staff on duty to meet the needs of the people living at the home. People told us ''The staff are good, but need more of them.'' and ''My relative is cared for, the staff are good but they need more.'' A compliance action has been set for this and the provider must tell us how they plan to improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

A member of the management team was available on call in case of emergencies.

Is the service effective?

People had access to a range of healthcare professionals some of which visited the home.

A person who lived at the home and relatives we spoke with told us that they were happy with the care provided and felt the needs of the people who lived at the home had been met. It was clear from what we saw and from speaking with staff that they knew the people living there well.

Is the service caring?

People were supported by staff who were kind and respectful and we saw during the inspection that they were supportive to relatives of people living at the home. One person told us that they could help with their relatives care if they wanted to but didn't feel that they had to. Another person told us that '' I am always kept informed, I have no worries about my relatives care.''

Is the service responsive?

Before moving in the manager or a senior member of staff visited with the individual to determine if they could meet their needs and respond to their health needs and preferences for their every day lives such as taking a nap and sleeping with a light on. We saw that people were appropriately referred to relevant health professionals when their needs had changed. However, we also saw that at times monitoring of people's weight or fluid intake was not always consistent and we discussed this with members of staff and the manager who told us that they would address the situation.

Is the service well-led?

The home had a registered manager in post which indicates that the person is of good character, is physically and mentally fit and has the necessary qualifications, skills and experience.

The names of two other managers appear on the details for this service but they are no longer involved in the running of the home. We have discussed this with the manager who told us that they would take the neccessary actions to ensure that applications to remove their names were completed.

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People were asked for their feedback on the service and although the manager told us they had addressed any questions people had it was not always evidenced. We discussed this with the manager who told us that they would make the information available.

5, 10 June 2013

During a routine inspection

Some people living at the service had complex needs and were not able to verbally communicate their views and experiences to us. Due to this we have used a formal way to observe people in this review to help us understand how their needs were supported. We call this the 'Short Observational Framework for Inspection (SOFI).

We spoke with two relatives of people receiving care at the service. The comments that we received were very positive and demonstrated that people thought very highly of the care that was provided. One person said that the care their relative received was, "Fantastic". Another person told us that they, "Wouldn't want to look for anywhere else".

People told us that they felt the food was good and that there relatives had enough to eat. Choices were provided and drinks were given between meal times.

We saw that medicines were stored, administered and disposed of safely. People received their medicines at the time they needed them and in a safe way.

People who used the service were safe because their welfare needs were met by staff who were appropriately trained and supported to deliver the care people required.

5 December 2012

During a routine inspection

Because of the nature of the needs of the people living at the home we were only able to attain a small amount of feedback directly from people using the service. However, we made observations about how people were being supported throughout the day, and we have used this and our discussions with relatives and staff, and what we found when we checked records, to make our judgement.

We judged that people had received the care, support and treatment they required to meet their needs. However, the support provided to people wasn't always clearly reflected in people's care plans.

Medication had been managed safely on the whole but we found some areas of practice which failed to protect people against the risk of medication not being administered appropriately.

The staffing levels were sufficient to meet the needs of the people using the service. However, the way in which staff were deployed meant that there were occasions when people were left unattended in the communal lounge. The manager confirmed that she had made changes to how staff were deployed immediately following our visit.

People using the service and their relatives told us they would be happy to approach the manager if they had any concerns or complaints about the service and they felt confident that the manager would address any concerns. We found complaints had been investigated and responded to appropriately.

14 March 2012

During an inspection in response to concerns

Prior to our inspection visit to the service we were notified by an anonymous person that there were 'not enough' staff to meet the needs of service users. We were also told there was a high use of nursing agency staff covering shifts and concerns were raised with us relating to medicines management.

During the visit we spoke with four relatives and we listened to a number of different concerns. Some reported there were not enough staff across each of the shifts. We were told that a lack of continuity was a concern because of high numbers of agency staff working at the service. They told us that because of low numbers the lounge areas were left unsupervised and the service user's needs were not monitored by staff across each shift. We were told by relatives that they had initiated a recent meeting with senior managers to raise the concerns they had about the service.

We asked relatives about the management of medicines. They each told us that they were unhappy with the ways in which the medicines were managed and they gave examples of this. A range of medicines concerns were reported including finding medicines on bedside tables, medicines not been given to relatives and we were told of serious incidents resulting from these omissions.

31 October 2011

During an inspection in response to concerns

We spoke with staff who were aware of the policies and procedures for handling and recording medicines within the home. Copies of these documents were available for staff to access.

People were given their medicines at appropriate times. If medicines were refused, or if people were asleep, then staff would reoffer the medicine later. Staff made sure enough time was left between doses where necessary.

We heard the care workers talking to people kindly and patiently.

Medicines were stored securely at all times and were only accessible to trained staff. This protects people living in the home and helps to prevent the medicines from being misused.

4, 13 January 2011

During an inspection in response to concerns

On the day of the visit we talked to two visiting relatives. We asked questions about their views of the home and whether they believed there to be sufficient staffing levels to meet the needs of their relatives. We received very positive comments about this from both relatives. They said they had not seen occurrences when the home was short staffed. Examples were given to show that staff have time to sit with residents, they did not appear overly rushed and for some members of staff their care was considered 'exemplary'. Both relatives said there were no concerns with regard to the laundry arrangements at the home and there were no reported times when their parents did not have clean clothes available to use. Both explained that in their opinion staff were able to meet the needs of their parents at all times and there was a consistency of staff working at the home, even if at times they were not aware of whether staff were permanent or not.

During the visit we talked to one resident about her views for how well her needs were being met. We were told that this resident 'felt safe' in this home, she believed she was well cared for, staff were 'kind and considerate'. All of the feedback about staff and the care received was extremely positive, however a comment was made that 'staff were very busy and very often didn't have the time to sit and chat to residents'.