Gordon House Care Home

Gordon House is a ‘care home’. People in ‘care homes’ receive accommodation and nursing or personal care as a 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.

This was an unannounced inspection which took place on 9 July 2018. The last inspection was in June 2015 when the service was rated as ‘Good’.

The service had a manager in post who had made an application to CQC to become registered. A registered manager is a person who has registered with CQC 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 our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We found that staff’s suitability to work with vulnerable adults at the service had been checked prior to employment. For instance, previous employer references had been sought and a criminal conviction check undertaken.

Staff had received training which equipped them with the knowledge and skills to ensure people received adequate care. Staff had also received more specific training to meet the needs of people living with mental health illnesses.

Medication was managed safely and was administered by staff who were adequately trained. People who wished to self-medicate were supported by staff to do so safely, this helped to promote their independence.

Appropriate arrangements were in place for checking the environment was safe. For example, health and safety audits were completed on a regular basis and accidents and incidents were reported and recorded appropriately.

Care records contained detailed information to identify people’s requirements and preferences in relation to their care. People we spoke with told us that they had a choice in how they lived their lives at the service.

Quality assurance processes were in place to seek the views of people using the service and their relatives.

Staff sought consent from people before providing support. Staff we spoke with understood the principles of the Mental Capacity Act 2005 (MCA) to ensure people consented to the care they received. The MCA is legislation which protects the powers of people to make their own decisions.

People were involved in their care and there was evidence in their care records to show that they had been consulted about decisions. People’s hobbies and interests were recorded and catered for. For example, one person enjoyed horse riding and the home had supported him with visits to the stables.

A ‘community connections worker’ was employed by the service to support people take part in activities in the local community. For example, people were supported with attending health care appointments, this helped to promote people’s wellbeing. Some people were also supported with further education and attended computer courses.

We asked people about how they thought the service was managed and their feedback was positive.

Situated in North Liverpool and located close to public transport links, leisure and shopping facilities, Gordon House is registered to provide accommodation for up to 20 younger adults with severe or enduring mental health conditions. At the time of the inspection 18 people were living at the home. The location is a purpose-built, single storey property with single bedrooms and shared bathroom facilities.

A registered manager was in post. 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. The registered manager was not available on the day of the inspection; however operational management responsibilities were shared with a colleague who was available throughout.

All of the people that we spoke with told us that they felt safe living at Gordon House. We saw that people were kept safe because staff were vigilant in monitoring behaviours and indicators of abuse.

People living at the home had detailed care plans which included an assessment of risk. These were subject to regular review and contained sufficient detail to inform staff of risk factors and appropriate responses. In the care records that we looked at risk had been recently reviewed.

Throughout the inspection we saw that, in accordance with their care plans, people were free to leave the building and return as they chose. There was no requirement for people to sign in or out of the building or inform a member of staff. This meant that staff could not be certain who was in the building at any given time.

The home had conducted regular fire drills and testing of fire alarms and other emergency equipment. Emergency equipment was serviced annually in accordance with requirements. The fire risk assessment had been reviewed annually. Safety checks were also completed regularly on water temperatures, legionella and gas and electrical safety.

Staffing were recruited safely and deployed in numbers which were generally adequate to meet the care needs of people living at the home. However it was apparent that people were left without obvious access to staff support at various points throughout the inspection.

People’s medication was stored and administered in accordance with good practice. We spot-checked medicines administration records and stock levels for each of the people living at the home. We saw that records were complete and that stock levels were accurate.

Staff were suitably trained and skilled to meet the needs of people living at the home. The staff we spoke with confirmed that they felt equipped for their role. The training matrix and staff certificates showed that training was in date.

The records that we saw showed that the home was operating in accordance with the principles of the MCA. Capacity assessments were decision-specific and were focused on the needs of each individual. None of the people living at the home at the time of the inspection was being deprived of their liberty although staff demonstrated that they understood the MCA and DoLS well.

Food was prepared from fresh ingredients, well presented and nutritionally balanced. People’s preferences, allergies and health needs were recorded and used in the preparation of meals, snacks and drinks.

The people that we spoke had a good understanding of their healthcare needs and were able to contribute to care planning in this area. All staff spoke of having good links with community mental health teams, crisis services and psychiatrists and there was evidence seen in the care records of regular meetings taking place with the views of the person clearly recorded.

Throughout the inspection we saw staff engaging with people in a positive and caring manner. Staff took time to listen to people and responded to comments and requests. Staff spoke with people before providing care to explain what they were doing and asked their permission.

Each of the people living at the home that we spoke with said that they were encouraged and supported to be independent. Throughout the inspection we saw people moving around the building independently and engaging in activities of their own choosing.

Each of the people living at the home that we spoke with told us they received care that was personalised to their needs. We saw that staff delivered care in a different way to each person. People’s preferences and personalities were reflected in the décor and personal items present in their rooms.

Each of the people that we spoke with confirmed that they had been involved in their own care planning and felt that they were able to make decisions about their care. We saw clear evidence in care records that people had been involved in the review of care.

People were supported to follow interests and access activities on an individual basis as part of their care. Staff also organised group activities to reduce social isolation.

Information regarding compliments and complaints was clearly displayed and the provider showed us evidence of addressing complaints in a systematic manner. All of the people that we spoke with said that they knew what to do if they wanted to make a complaint.

Staff were able to access bi-monthly team meetings where important topics were discussed. We saw evidence that discussions regarding quality and feedback from people living at the home had taken place.

The home had a clear vision and values. Each member of staff that we spoke with was able to explain that the home existed to provide a safe place for people to live and to provide a platform for recovery.

Staff were motivated to provide good quality care and were well supported by the provider. They understood their roles and responsibilities and what was expected of them regarding the provision of care and general conduct.

The provider had systems in place to monitor safety and quality and to drive improvements. We saw evidence of a quality assurance programme which detailed requirements and themes for each month. The registered manager and other senior managers completed a series of audits which included information that was fed-back to the staff team.

People told us they were happy at Gordon House and were very positive about the support provided by staff. Comments included, "Staff listen to you and will acknowledge the difficulties you are having" and "You can relax here, I feel safe and trust the staff." People told us that staff were responsive to changes in their health and that staff supported them to be as independent as possible.

The staff members on duty during our visit had many years experience between them which provided them with the right competencies, skills and knowledge to meet the needs of people at the care home. Although the complaints log could have been organised better, people using services and staff were well aware of the process for making and recording complaints and how to escalate unresolved issues.