• Care Home
  • Care home

Archived: Gilbert Scott Care Home

Overall: Good read more about inspection ratings

Old Weston Road, Flax Bourton, Somerset, BS48 1UL (01275) 464875

Provided and run by:
The Brandon Trust

All Inspections

7 January 2017

During a routine inspection

Gilbert Scott Care Home provides accommodation and personal care for up to 5 people with learning disabilities. At the time of our inspection there were four people with diverse and complex support needs living in the home.

The service had a registered manager at the time of inspection. 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 inspected the home in July 2015 and identified concerns related to the implementation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), the environment people lived in, the governance of the service and how people were treated with respect. We took enforcement action and told the provider to make improvements in how people were treated with respect and the implementation of the MCA and DoLS and during an inspection on December 2015 we found these improvements had been made.

At this inspection we found that improvements had also been made regarding the environment and governance of the service.

People felt safe and well cared for, they were relaxed in staff company and sought out staff when they needed assistance. They were protected from harm because staff understood how to reduce the risks they faced. They also knew how to identify and respond to abuse and told us they would be confident to do so.

People had support and care when they needed it from staff who had been safely recruited and understood their needs. Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills to support the individuals living in the home. Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection.

People saw health care professionals when necessary. Records reflected that staff responded appropriately to emerging, ongoing and emergency healthcare needs. People received their medicines as they were prescribed.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their lives. Care plans and practice reflected the framework of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards had been applied for when people needed to live in the home to be cared for safely but did not have the mental capacity to consent to this.

The home was clean throughout and how there was on going work related to how people could make the most of the space available for leisure, relaxation and daily living.

People were engaged with individual activities that reflected their preferences both within their home and the local area.

People had food and drinks that reflected their preferences and there were systems in place to ensure people had enough to eat and drink. When people needed particular diets or support to eat and drink safely this was in place.

Quality assurance had led to improvements being made and staff were actively encouraged to contribute their views to this process. People could not contribute verbally to improvement plans but their wishes, needs and reactions to changes were reflected in all improvement planning and review undertaken. Staff and professionals spoke positively about the management and staff team as a whole.

3 December 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 27 and 28 July 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulations 10 and 11.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. We also followed up other areas where the provider needed to improve the service, although they had not breached legal requirements. This report only covers our findings in relation to these issues. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gilbert Scott Care Home on our website at www.cqc.org.uk

This inspection was unannounced and took place on 3 December 2015.

Gilbert Scott is a care home which provides accommodation and personal care for up to four people with a learning disability who may also have additional complex needs. During our inspection there were four people living at the home. The people living at Gilbert Scott were unable to verbally communicate their needs and relied on staff to support them with all aspects of their care and support.

There was a registered manager, however they were absent from the service. 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 registered manager had been absent since November 2015. A manager who was registered with another location was managing the home in their absence.

At the last inspection we found people’s rights were not fully protected because procedures were not always followed where people lacked capacity to make decisions for themselves. At this inspection we found the correct procedures had been followed. Where decisions were made for people the principles of the Mental Capacity Act 2005 were adhered to and staff were able to demonstrate their knowledge and understanding of these processes.

At the last inspection we observed mixed interactions between staff and people. Staff did not always demonstrate a good knowledge of the people they were supporting or respond to their needs. We found some of the interactions did not promote dignity and respect. Some of the comments recorded about people in records did not promote an understanding of people’s needs. At this inspection we found staff demonstrated an understanding of people’s needs and how they responded to them. Staff had attended training on how to record information and they told us the importance of using the correct terminology when recording information.

27 and 28 July 2015

During a routine inspection

The inspection took place on 27 and 28 July 2015 and was unannounced.

Gilbert Scott is a care home which provides accommodation and personal care for up to five people with a learning disability who may also have additional complex needs. During our inspection there were four people living at the home. The people living at Gilbert Scott were unable to verbally communicate their needs and relied on staff to support them with all aspects of their care and support.

There was a registered manager in post at the service. 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 registered manager did not have effective systems in place to monitor the quality of the service. The Department of Health’s Code of Practice on the prevention and control of infections and related guidance was not being followed at the time of our inspection. There were areas of the home requiring maintenance and repair. The registered manager told us there were plans to improve the environment, however these were on hold due to the home potentially closing.

We found people’s rights were not fully protected as the registered manager had not followed correct procedures where people lacked capacity to make decisions for themselves. We observed where decisions were made for people the principles of the Mental Capacity Act 2005 were not always followed.

Staff understood the importance of recording incidents, however the records did not always include enough details of the incident.

Our observations of staff interactions was mixed, staff did not always demonstrate a good knowledge of the people they were supporting or respond appropriately to their needs. Staff were supporting people to raise complaints as they were unable to verbally communicate these. The complaints were recorded however recent complaints had not been reviewed by the registered manager and there were no recorded outcomes.

People did not have an inclusive mealtime experience, staff served meals through a hatch and people were locked out of the kitchen unless staff were present.

People’s relatives told us they thought their family members were safe living at Gilbert Scott. Staff knew how to recognise potential signs of abuse and were aware of their responsibility to report this. There were enough staff available to meet people’s needs.

There were recruitment procedures in place to ensure only staff with suitable character were employed by the organisation. Staff received appropriate training to understand their role and to ensure the care and support provided to people was safe. New members of staff received an induction which included shadowing experienced staff before working independently.

People’s medicines were administered safely. The service had appropriate systems in place to ensure medicines were stored correctly and securely. People received their medicines when they needed them.

Plans were in place to manage risk relating to peoples care. Relatives told us they were aware of and involved in reviewing the risk assessments.

People’s needs were set out in individual care plans. The plans set out what people could do for themselves and the support they required from staff. The care plans were regularly reviewed and updated by staff. Relatives told us they were involved in planning and reviewing their family members care.

People had access to a house vehicle and were able to access the community.

Relatives told us they felt confident about raising concerns with the team leaders or registered manager. The service collated feedback from people’s relatives in order to obtain their views on the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We have made recommendations to the provider, you can see what the recommendations were in the full version of the report.

18 July 2013

During a routine inspection

At the time of our visit there were four people living at Gilbert Scott. Due to their complex needs we were unable to discuss their experiences of living in the home and the care and support that was in place.

However, we made observations of their care and spoke with four members of staff. In addition we looked at care records and risk assessments for two of the four people.

People living in the home were supported to participate in making decisions about their own care and treatment. Where people did not have the capacity to make complex decisions, we saw that procedures were followed to ensure that decisions made on their behalf were done so in the person's best interests.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were encouraged to be independent, they were observed being supported to make drinks, move freely around their home and the garden and clear away the table after lunch. People were supported on a regular basis to access the community.

Appropriate arrangements were in place in relation to the recording of medicine. Medicines were safely administered.

There were enough qualified, skilled and experienced staff to meet people's needs.

There was a suitable system in place to check the quality of care and the overall service people received.

13 September 2012

During an inspection looking at part of the service

This visit was to look specifically at an issue identified at our last visit in May 2012. In order to check on the progress made, we reviewed documentation to show that people and their relatives were being involved in decisions concerning their care.

People living at Gilbert Scott House were not able to talk with us, due to their complex communication needs. On the day of our visit, two of the four people who lived at Gilbert Scott House were present and both appeared settled and relaxed.

22 May 2012

During a routine inspection

At the time of our visit, there were four people living at Gilbert Scott Care Home. Due to their complex needs, they were not able to discuss their experience with us verbally. However, we made observations of their care and spoke with support staff.

We saw that one person gave a 'thumbs up' sign to tell a member of staff that he was ok and happy. This person also initiated communication with a member of staff and they discussed going out for a walk. The member of staff used makaton signs to support their verbal communication.

We saw that staff engaged with people in a calm and relaxed manner. On one occasion, an individual was becoming agitated and we saw that a member of staff gently encouraged him to "calm down" and used a gesture to support her verbal communication.

We saw that another person was being given space to engage in one of his favoured activities of handling stones.

Staff were knowledgable about the people that they were caring for. For example staff told us that one person's favourite activity was 'pegging'. We were told that arrangements were being made to give this person a larger room to accomadate a table where he could engage in this activity.

19, 20 January 2011

During a routine inspection

The people who live in Gilbert Scott House are not able to verbalise their views and opinions but we are assured by what we observed and by what the staff told us, that they are well looked after and receive the care and support that they each individually need.

The staff team are respectful and ensure that people are involved as much as possible in decisions that affect their lives. They are aware of those times when they need to make best interest decisions about aspects of peoples care, and who to also involve in this process.

The home is comfortable, safe and well maintained.

People are looked after by a stable staff team meaning that there is consistency in the care provided. The staff have access to a wide range of training opportunities and are well supported to carry out their role.

There are good monitoring systems in place to ensure that the service provided for each individual is appropriate to their specific needs. Any concerns or complaints people may have will be addressed appropriately and staff are able to identify when people are unhappy because they know them well and can interpret changes in behaviours