We carried out a review of the data available to us about Gorse Hill 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 Gorse Hill, you can give feedback on this service.
Gorse Hill provides accommodation and personal care for up to 10 people with a learning disability. At the time of our inspection, there were 5 people living in the home.
People’s experience of the service and what we found:
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The service demonstrated how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support
People were supported in a kind, sensitive and respectful way. People received person centred support and their needs were met. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. Staff were recruited safely, and relevant checks had been carried out. People were supported by staff who had been trained and were appropriately supervised. People’s needs were assessed prior to the receipt of service. Care and support had been developed around individual assessed needs and preferences. Staff worked in a way which promoted people's independence. People were supported to access healthcare services to ensure their health needs were met. People received their medicines in a safe way.
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 practice.
Right Care
People were positive about the care and support they received. People were treated with dignity and respect, and their independence was encouraged. Staff understood how to protect people from poor care and abuse. People had personalised support plans which considered their needs and preferences. Any risks to people’s health and well-being had been assessed, recorded and mitigated as much as possible.
People could take part in activities and pursue interests that were tailored to them. The staff gave people opportunities to participate in a wide variety of activities that enhanced and enriched their lives. Staff knew people well and communicated effectively with them to ensure they felt understood and valued.
Right Culture
The registered manager and staff promoted a person-centred culture which was focused on meeting people's individual needs. The registered manager was committed to the continuous improvement of the service. The registered manager and staff sought feedback and worked in partnership with others including health and social care professionals to ensure people received the support they needed. Staff had access to a wide range of relevant training which was refreshed at regular intervals. The provider had established effective systems to monitor the quality of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good (published 29 September 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Gorse Hill provides accommodation and personal care for up to ten people with a learning disability. The home is set in its own grounds and is located near to local amenities. All accommodation is single occupancy, with some rooms taking the form of a small flat, with kitchen, living and bathroom areas. All bedrooms have an ensuite bathroom. At the time of the inspection there were eight people accommodated in the home.
The last inspection was carried out on 3 and 6 July 2015. Whilst we rated the service as overall “Good”, we found there were shortfalls in the implementation of the Mental Capacity Act (MCA) 2005. During this inspection, we found the necessary improvements had been made and the service was meeting all the current regulations.
People using the service told us they felt safe and staff treated them well. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and welfare had been assessed and preventive measures had been put in place where required. People received their medicines safely and were supported to have a healthy diet.
Staff had the knowledge and skills required to meet people's individual needs effectively. There were arrangements in place for all new staff to complete a structured induction programme, which included the provider’s mandatory training. Staff were provided with a refresher training on an ongoing basis. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s healthcare needs were monitored as appropriate.
Staff treated people in a respectful and dignified manner and people's privacy was respected. People were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes. We observed people were happy, comfortable and relaxed with staff. Care plans and risk assessments provided guidance for staff on how to meet people’s needs and were reviewed regularly. People were encouraged to build their independence skills and were supported to participate in a variety of daily activities.
The complaints procedure provided information on the action to take if a person wished to raise any concerns. People were aware of the complaints procedure and processes and were confident they would be listened to.
Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. The arrangements in place for gathering people’s views about the service were mostly informal; however, the registered manager was working to an action plan, which included the distribution of satisfaction questionnaires. The registered manager also intended to record discussion and agreements following residents’ meetings. All people spoken with were satisfied with the service and felt the management team and staff were approachable, helpful and supportive.
We carried out an inspection of Gorse Hill on 3 and 6 July 2015. The first day of the inspection was unannounced.
Gorse Hill provides accommodation and personal care for up to ten people with a learning disability. The home is set in its own grounds and is located near to local amenities. All accommodation is single occupancy, with some rooms taking the form of a small flat, with kitchen, living and bathroom areas. All bedrooms have an ensuite bathroom. At the time of the inspection there were nine people accommodated in the home.
The service had a registered manager 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.
At the last inspection on 19 and 20 January 2015 we asked the provider to ensure appropriate action was taken following a safeguarding incident and ensure the commission was notified in a timely manner. Following the inspection the provider sent us an action plan which set out the action they had taken to ensure the regulations were met. On this inspection we found the necessary improvements had been made.
As Gorse Hill is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found staff had completed training on the Mental Capacity Act 2005 and had access to appropriate policies and procedures. However, on arrival at the service we noted one person was walking down the road and was persuaded back by the registered manager. We noted a mental capacity assessment had not been carried out to determine if the person was able to go out safely on their own. We further noted a DoLS application had not been made which meant the person was deprived of their liberty without proper authority. You can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe and were well cared for in the home. Staff knew about safeguarding procedures and we saw concerns had been dealt with appropriately, which helped to keep people safe.
We noted there were sufficient numbers of staff on duty to support people safely and ensure that people’s needs were met appropriately.
Systems and processes were in place to ensure the administration, storage, disposal and handling of medicines was safe.
We found relevant checks had been completed before a member of staff started to work in the home. From the records seen and discussions with staff we also noted staff had completed relevant training for their role and they were well supported by the registered manager.
Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink.
All people had a detailed care plan which covered their needs and any personal preferences. People were given the opportunity to discuss their care at monthly keyworker meetings.
People were able to participate in a variety of activities both inside and outside the home. We noted staff were allocated specific time on the rota to enable them to spend individual time with people.
Staff understood the needs of people and we saw that care was provided with kindness and compassion. People spoke positively about the home and the care they received.
People and their relatives told us they knew who to speak to if they wanted to raise a concern. There were systems in place for responding to complaints.
We saw there was a system of audits in place to monitor the quality of the service. People and staff were given opportunities to express their views and provide feedback on the service.
We carried out an inspection of Gorse Hill on 19 and 20 January 2015. The first day was unannounced. We last inspected Gorse Hill on 20 January 2014 and found the service was meeting the current regulations. However, during this inspection we found the care home provider was required to make improvements in the following areas: taking appropriate action following a safeguarding incident and notifying the commission of incidents in a timely manner. We also made a recommendation about the development of suitable activities.
Gorse Hill provides accommodation and personal care for up to ten people with a learning disability. The home is set in its own grounds and is located near to local amenities. All accommodation is single occupancy, with some rooms taking the form of a small flat, with kitchen, living and bathroom areas. All bedrooms have an ensuite bathroom.
The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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.
All staff spoken with were aware of the procedures in place to safeguard people from harm. However, a recent incident in the home had not been reported to the local authority under safeguarding procedures. We also found there was no evidence to demonstrate how this incident was being investigated. An alert was made following our inspection.
We found the arrangements for managing people’s medicines were safe. We found accurate records and appropriate processes were in place for the storage, receipt, administration and disposal of medicines.
As Gorse Hill is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate information was available on the Mental Capacity Act 2005 (MCA 2005) and two applications had been made to the local authority for a DoLS. Staff had completed training and had a working knowledge of the MCA 2005.
We found staff recruitment to be thorough and all relevant checks had been completed before a member of staff started to work in the home. Staff had ongoing opportunities for training and there were systems in place to ensure staff completed the training in a timely manner. Whilst people’s needs were met, on the first day of our inspection there were fewer staff on duty than the provider’s usual level of staffing.
Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink.
All people had a detailed care plan which covered their needs and any personal preferences. We saw the plans had been reviewed on annual basis, however, we found the keyworker monthly reviews were not always completed. This meant there was the potential for not picking up small changes in people’s needs and wishes.
We observed an inconsistency in the caring approach by staff. One person told us they were concerned they did not always receive the one to one time they were funded for. This meant there was the potential for this person’s needs not to be fully met.
Whilst there were systems in place to assess and monitor the quality of the service, we found the arrangements in place to manage the service required improvement.
Our findings demonstrated a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and a breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.