Archived: Gosberton House Care Home

Updated 12 December 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

Our inspection was conducted by an inspector, a specialist adviser whose specialism is nursing and an 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:

Gosberton House Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. Two weeks before our inspection the registered manager had started her maternity leave. To cover her absence, the registered manager’s deputy had taken on the role of acting manager. On the second day of our inspection, the registered manager came in to meet with our inspector and contribute to the inspection process.

Notice of inspection:

This inspection was unannounced.

What we did:

In planning our inspection, we reviewed information we had received about the service since the last inspection. This included information shared with us by other agencies and any notifications (events which happened in the service that the provider is required to tell us about).

During our inspection we spoke with nine people to ask about their experience of the care provided. We also spoke with three family members, one of the cooks, two care staff, a nurse, the acting manager, the registered manager and a visiting healthcare professional.

We reviewed a range of written records including six people’s care plans, two staff recruitment files and information relating to staff training and the auditing and monitoring of service provision.

Updated 12 December 2019

About the service:

Gosberton House Care Home is registered to provide accommodation and support for up to 46 people, including older people and people with a physical disability. There were 44 people living in the home on the first day of our inspection.

The registered provider also provides day care in the same building as the care home. This type of service is not regulated by the Care Quality Commission (CQC).

People’s experience of using this service:

The provider was failing to provide people with consistently safe, effective, caring, responsive or well-led care.

The provider had failed to organise staffing resources safely and effectively to meet people’s needs and preferences. The management of people’s medicines was not consistently safe.

Some people’s care plans and individual risk assessments were out of date. Records indicated that staff sometimes failed to meet the requirements of people’s care plans, in areas including nutrition and skin care. Staff did not always follow current best practice guidance in their delivery of care. The provider’s approach to quality monitoring was not consistently effective.

Some staff used institutional, impersonal language to refer to people living in the home. The provider had failed to maintain confidentiality in respect of people’s personal information. There was limited evidence to indicate people who stayed in bed or in their room were provided with sufficient stimulation.

In other areas, the provider was meeting people’s needs.

Staff worked collaboratively with local health and social care services to ensure people had support when required. Systems were in place to ensure effective infection prevention and control. Staff were provided with regular training and supervision. Staff recruitment practice was safe.

Staff worked in a non-discriminatory way and promoted people’s independence. Staff worked in a generally person-centred way, responding to people’s individual needs and preferences. People felt safe living in the home. Staff knew how to recognise and report any concerns to keep people safe from harm.

Staff were aware of people’s rights under the Mental Capacity Act 2005 and supported people to have maximum choice and control of their lives, in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

The registered manager and acting manager provided strong, supportive leadership. The owners of the home visited regularly and were well-known to people, their relatives and staff. The provider notified CQC and other organisations of issues as required. There was learning from significant incidents and any complaints were managed in line with the provider’s policy. The provider was committed to the continuous improvement of the service in the future.

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 this service was Good (published 1 June 2017). At this inspection we found a deterioration in the quality of the service. The rating is now Requires Improvement and the provider is in breach of regulations.

Why we inspected:

This was a planned inspection based on the previous rating.

Enforcement:

We have identified two breaches of regulations reflecting the provider's failure to monitor service quality effectively and failure to organise staffing resources safely and effectively.

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

Follow up:

We have requested an action plan from the provider to address the breaches of regulations identified at this inspection. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.