Archived: Gallions View Care Home

We received further concerns about the service and carried out a focused inspection on 7 March 2016. At this focused inspection we found continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014 in relation to safe care and treatment and monitoring the quality and safety of the service. We placed a condition on the service’s registration that no new admissions could be made to the home.

Gallion’s View Nursing Home provides personal care and nursing care to older people and those living with dementia. The service can accommodate up to 120 people in four separate buildings. At the time of this inspection 82 people were using the service. The day before our inspection one of the units was temporarily closed and people who used the service were moved to two out of the three remaining units.

The service had a registered manager who has been in post since 2011. 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. However, at the time of our inspection the registered manager had been on extended leave since June 2016. The deputy manager was managing the service as acting manager and was being supported by the provider’s recovery team who oversee and support improvement

At this inspection we found continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014.

People’s safety had been compromised in that medicines were not always managed safely. Risks to people had been identified but care plans did not always record guidance in order for staff to enable staff to manage these risks safely accident and incident logs were not always completed. Audits had either not been carried out or were not always effective in identifying shortfalls in the safety or quality of the service

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded

Mental capacity assessments and ‘best interests’ meetings were not always carried out in with the MCA when there were concerns regarding a person’s ability to make a decision. Care plan audits did not always identify the risks recorded by healthcare professionals and people were not always referred back to healthcare professionals for follow ups or reviews. Care plans did not always record guidance for staff on how to support and meet people’s needs. Complaints were not logged, investigated, monitored or maintained in line with the service’s complaints policy. The number of staff deployed across the three units, were not always enough to meet the needs of people who used the service. Staff did not feel consulted or involved in the running of the service and told us communication with management was poor. You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.

We saw at times staff interaction with people was limited unless they were task orientated. We found activities offered at the home required improvement to meet people’s needs for stimulation and social interaction.

Safeguarding adult's procedures were robust and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.

Staff received supervision, appraisals and training appropriate to their needs and the needs of people they supported to enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.

Staff respected people’s privacy and dignity. Staff knew people well and remembered things that were important to them so that they received person-centred care. People's nutritional needs and preferences were met.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to consider the process of preventing the provider from operating this service. This may lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement and there is still a rating of inadequate for any key question or overall, we may take action to prevent the provider from operating this service. This may lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Gallion’s View Nursing Home provides personal care and nursing care to older people and those living with dementia. The service can accommodate up to 120 people in four separate buildings. At the time of this inspection 57 people were using the service.

The service had a registered manager who has been in post since 2011. 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. At the time of our inspection the registered manager had returned to work the previous month after being on extended leave since June 2016. The deputy manager had been managing the service as acting manager during the registered manager’s absence and had been supported by the provider’s recovery team who oversee and support improvement.

This inspection was in line with our special measures policy to check if improvements had been made. We found that the provider had made some improvements. They were now compliant with the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to consent and complaints. However, we found two continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014, in relation to safe care and treatment and monitoring the quality and safety of the service. In February 2016 we required the provider to submit information to us on a monthly basis and have continued to voluntary submit monthly audits when the condition ended in September 2016. In March 2016, we placed a condition on the service's registration that no new admissions could be made to the home. Following this inspection, this condition will remain on the provider’s registration as a continued breach of regulations was identified. We have also asked the provider to submit a protocol that details the way staff are kept informed of people’s needs and risks when staff are required to work on other units part way through a shift. The provider has also agreed to continue to send us voluntary monthly audits.

As the provider has demonstrated improvements and the service is no longer rated as inadequate for any of the five key questions, it is no longer in special measures.

Risks to people had been identified but care plans did not always record up to date guidance in order to enable staff to manage these risks safely. Staff were not always aware of people’s needs before they offered support. Audits were not always effective in identifying shortfalls in the safety or quality of the service. You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.

The service had appropriate safeguarding adults procedures in place and staff had a clear understanding of these procedures. There was a whistle-blowing procedure available and staff said they would use it if the need arose. Medicines were managed, administered and stored safely. There were safe staff recruitment practices in place and appropriate numbers of staff deployed to meet people’s needs.

New staff were adequately inducted into the service; staff received appropriate training and were supported through supervisions and appraisals. Staff were aware of the importance of seeking consent from the people they supported and acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) where people lacked capacity to make decisions for themselves. People were protected from the risk of poor nutrition and had access to a range of healthcare professionals in order to maintain good health.

Staff respected people’s privacy and dignity and treated them with kindness and consideration. People were supported to be independent where possible such as attending to aspects of their own personal care. Staff were knowledgeable about people's cultural needs and religious beliefs.

People’s needs were assessed and they or their relatives were involved in the care planning process. Care plans were reviewed on a regular basis, but were not always updated to reflect a change in people needs and the support they required. People were provided with information on how to make a complaint and said they were confident that their complaints would be investigated and action taken if necessary. A variety of activities were available to engage and stimulate people. People and their relatives were asked for their views about the service through residents meetings and satisfaction surveys. Regular resident and staff meetings were carried out; people, their relatives and staff spoke positively about the leadership.

You can read the report from our last inspection, by selecting the 'all reports' link for 'Gallions View Home' on our website at www.cqc.org.uk.’

Gallion’s View Nursing Home provides personal care and nursing care to older people and those living with dementia. The service can accommodate up to 120 people in four separate buildings with 30 single rooms in each. Each unit has a dining room and sitting areas. At the time of this inspection 101 people were using the service

The service had a registered manager who has been in post since 2011. 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.

At this inspection we found continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014.

Risks to people had not always been identified or properly assessed, and action had not always been taken to manage risks safely. CQC is considering the appropriate regulatory response to resolve the problems we found and will report on any action taken when it is completed.

Systems the provider had in place to audit and check the service were not effective. These checks covered aspects of the service including; equipment, the accuracy of people's records and staff training. CQC is considering the appropriate regulatory response to resolve the problems we found and will report on any action taken when it is completed.

At our visit we found that the provider had made improvements to ensure that before people received any care or treatment they were asked for their consent. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Improvements had also been made to ensure care records and other service documents were up to date and stored securely.

At our visit we found that people's needs were mostly assessed correctly and care was delivered according to their needs. Staff were recruited appropriately and the provider worked with other health and care professionals to ensure people's health, safety and welfare was protected. However, we also found that the provider had not always assessed correctly people's capacity to make decisions and people's care records were not all accurate and fit for purpose.

We found that the staff received support and training in different aspects of care. Care records were stored securely and were mostly accurate.