We carried out a review of the data available to us about Gatesgarth on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gatesgarth, you can give feedback on this service.
Gatesgarth is a residential care home providing personal care and accommodation to five people with a learning disability. The home is a bungalow in a community setting and designed to promote people's inclusion and independence.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service:
People received a consistently good service and felt safe with the support they received from the staff. Staff had developed caring and trusting relationships with people, with many staff being employed in the home for over ten years and more.
There was a strong, visible person-centred culture. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.
People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were encouraged and supported to engage in activities within the community.
People were safeguarded against the risks of abuse and harm by the systems and by the staff training in place. Risks to people were assessed and mitigated. When incidents took place, the provider reflected on events to help reduce the risk of these happening again.
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.
Staff had undertaken training which was regularly updated to ensure they had the skills and knowledge to support people effectively. The registered manager ensured there was always enough staff to provide flexible and responsive care.
People had access to external health professionals to help promote good health and wellbeing. They were encouraged to maintain a healthy diet and had support to take their medicines safely.
The home was well run. There was a new registered manager in post who had a good oversight of the service and was experienced in their role. The staff team were positive about the new manager’s input and keen to develop the service further for the benefit of people 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 the service was good (published 17 February 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.
Community Integrated Care run Gatesgarth and provide care and services for up to five people living with a learning and/or a physical disability. They operate a number of similar facilities in Cumbria and other parts of the country. Gatesgarth is located in a quiet residential area in the village of Little Broughton, just outside the town of Cockermouth. Accommodation is in single rooms and the house is specially adapted for people with mobility needs.
The service has a suitably qualified and experienced registered manager who runs Gatesgarth and one other small 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.
At the last inspection on 25 June 2015 we asked the provider to take action to make improvements to staffing levels. The provider sent us an action plan after the inspection and at this inspection we judged that this action has been completed. The home had increased the staffing levels and the registered manager was keeping this under review as people's dependency changed. Staff were suitably inducted, trained and developed to give the best support possible.
The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and there had been no safeguarding issues in the service. Good risk assessments and risk management plans were in place to support people. Suitable arrangements were in place to ensure that new members of staff had been suitably vetted and were the right kind of people to work with vulnerable adults. There had been no accidents or incidents of note in the service.
Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary.
The registered manager was aware of her responsibilities under the Mental Capacity Act 2005 when people were deprived of their liberty for their own safety. We judged that this had been done appropriately and that consent was always sought for any interaction, where possible.
People told us they were happy with the food provided. We saw that the staff team made sure people had proper nutrition and hydration.
The house was suitably adapted to meet people's needs and had recent improvements to floor coverings and décor. Infection control was suitably managed and the home was clean and comfortable when we visited.
We observed kind, patient and suitable care being provided. Staff made sure that confidentiality, privacy and dignity were adhered to. People were encouraged to be as independent as possible.
Assessments and care plans were up to date and met the meets of people in the service. Staff were very centred on the needs of individuals.
People were happy with the activities and entertainments on offer. Some people went to day centres. Everyone was given the opportunity to follow their own interests.
The service had a suitable complaints policy in place but no formal complaints had been received.
The service had a suitable quality monitoring system in place and action was taken if improvements were needed.
We carried out an unannounced inspection on the 25 and 26 June 2015. We last inspected the service on the 3 April 2013 and we found the home was complaint with the regulations.
Gatesgarth is a care home for five people who live with a learning disability, some of whom also have support needs associated with limited mobility. The home is a detached dormer bungalow adapted for its current use as a care home and it is situated in the village of Little Broughton, three miles from the town of Cockermouth.
Accommodation is provided on two floors, with just one bedroom being upstairs. The home has a range of equipment suitable to meet the needs of the people living there. It has a lounge, dining room and wide corridors for those who use a wheelchair to get around. Bathrooms and showers rooms have been adapted to meet the needs of people in the home.
There was a new registered manager who had been employed at the home for just over six months. 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 and associated Regulations about how the service is run.
The manager was registered for this home and to run two other small homes nearby. These were also run by the same provider, Community Integrated Care (CIC). CIC are a large national charity providing services for people who are living with a learning disability.
People we spoke with told us that they felt safe in the home and with the care provided by the home. However, we judged that staffing numbers were unsafe in that they did not meet all aspects of people’s needs. A number of people’s care support needs required two members of staff and other people required close supervision.
We found that at the weekend there were often only two members of staff on duty, when during the week there could be four care staff plus a manager. Staff had to undertake shopping, cleaning, laundry and cooking duties, as well as providing care and support to people. We found that this meant there were insufficient staff to meet people’s needs and to keep them safe at weekends.
People’s ability to choose to go out and to take part in activities was therefore also limited at weekends. We saw that this had an adverse effect on some people’s quality of life at weekends, and led to an increase in behaviours that could be a challenge to the service.
We have made a recommendation that the service looks at how they work out staffing levels to make sure that they meet both people’s individual care and their social needs.
Overall risks were being managed well at the home because comprehensive assessments were carried out and these risk plans adhered to. Staff were well versed in the safeguarding of vulnerable adults and records we, CQC, held indicated that the home cooperated with the local safeguarding authority.
People were cared for by well trained, competent and confident staff. Every effort was made to ensure that people’s rights to consent to, and refuse, treatment were respected. This included following appropriate guidance when people lacked capacity to make their own decisions
People were provided with meals and drinks that they enjoyed. We found that people’s nutritional needs were routinely assessed and monitored from time to time to ensure that they had healthy diets and life styles.
People in the home had regular access to health care. They went out to health appointments and there was evidence of good measures in place to prevent ill health. Medicines were well managed and stored correctly.
We saw that people were being treated with dignity, respect and care. There were affectionate and caring relationships between the care staff in the home and the people who lived there. The staff knew how people communicated and gave people the time they needed to make choices about their lives and to communicate their decisions.
Assessments of people’s needs were comprehensive and took into account people’s likes and dislikes. Support plans were based on assessments and gave clear strategies as to how to meet people’s needs.
There was no restriction on when people could visit the home. People were able to see their friends and families when they wanted.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, with regard to staffing levels. You can see what action we told the provider to take at the back of the full version of this report.
We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We judged that people were leading interesting lives of their choosing and were being supported to stay healthy and well.
There were effective managerial systems in place to monitor that people living at the home received a good standard of care and support.
Relatives told us they were 'very happy' with the care their relative received and had no complaints. They said, 'We just pop by whenever we feel like it and are always made to feel welcome.' They told us they had been particularly impressed with how staff had managed a complex healthcare problem and this had resulted in a 'vast improvement' in their relative's quality of life.
We spoke with these three people who told us that they were very happy living at the home, saying "the staff are great".
We observed people having plenty of positive interactions with staff. Both staff and residents obviously enjoying each others company; laughing, having jokes and sharing friendly banter.