Gardens Neurological Centre

Updated 21 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by 2 inspectors, 1 medicine inspector, 1 Specialist Advisor and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gardens Neurological care centre a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gardens Neurological care centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and 6 relatives about their experience of the care provided. We spoke with 18 members of staff including the registered manager, pharmacist, clinical lead, management and care workers. We spoke with 2 professionals. We reviewed a range of records. This included 6 people's care records and a variety of medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 21 December 2023

About the service

Gardens Neurological Centre is a residential care home providing accommodation personal and nursing care to up to 52 people. The service provides support to people with complex neurological conditions, brain or spinal injuries. At the time of our inspection there were 44 people using the service.

People’s experience of using this service and what we found

People did not receive their medicines safely and usually as prescribed and we could not be assured staff were always following prescribers’ instructions when administering medicines.

People were not always supported by staff who had received the necessary training to support them. Although when speaking with staff they felt they had the skills and experience to support people.

People's nursing needs were assessed and care and support was delivered in line with current standards, however further consideration needed to be taken to develop care plans detailing people's social and wellbeing needs.

People’s individual needs were not always met by the adaptation, design and decoration of the premises. It varied between individuals’ rooms; in some instances, they were decorated and personalised for people and others did not. The management team stated they offered the options for people to personalise their bedrooms.

The provider assessed risks to ensure people were safe. Staff took action to mitigate any identified risks.

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The registered manager and staff worked well with other agencies to do so.

People were supported by staff who treated them with respect and staff were kind and caring

Managers completed quality audits which covered all aspects of care, although some of these audits did not identify the issues, we found in the quality of care provided by some staff. There was a recent change in provider; the new provider was starting to implement a number of positive changes. Staff felt supported by managers.

Staff had not always completed people's mental capacity assessments accurately. In some cases, the content of the assessment indicated the person did not have capacity, however when speaking to the person it was evident the person had capacity to make the decision

There had been a change in management over the past 11 months working through an improvement plan for this location, where they identified some poor practices and failings which they are starting to work through. However, we found a range of problems for which we gave the provider breaches in relation to medicines and care planning. There were other failings which we accept the provider was working on we have asked for an action plan which we will be looking at closely.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 under the previous provider was good, published on 25 December 2021.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to the lack staff training, medicine management and people not receiving person centred care at this inspection.

We have made recommendation about people's social and wellbeing needs.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.