Background to this inspection
Updated
9 April 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors on 19 February and by one inspector on 20 February.
Service and service type
Gorselands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed the information we had received about the service including notifications of incidents and accidents which they are required to send us by law. We also sought feedback from the local authority quality monitoring team. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five people who used the service and three relatives about their experience of the care provided. We spoke with three members of the care staff including one senior, the chef, the quality assurance manager, the registered manager and the provider.
We reviewed a range of records. This included four people’s care records and three medication administration records. We looked at one staff file in relation to recruitment and at other records relating to training and staff supervision. We also viewed other records relating to the quality and safety of the service.
Updated
9 April 2020
About the service
Gorselands is a residential care home registered to provide personal care for up to 21 older people, some of whom may be living with dementia. There were 16 people using the service when we inspected. The building is a large period property with communal areas and bedrooms on two floors. There is a lift to the second floor.
People’s experience of using this service and what we found
Following the last inspection, the provider and registered manager had undertaken a review of the systems and procedures which had contributed to the Inadequate rating and the service remaining in Special Measures. The actions taken following this review were clear to inspectors and there was evidence of improvement throughout the service. However, further work was still needed to address the concerns identified during this inspection and to ensure the improvements already made were fully embedded and sustainable.
People who were able to, had consented to their care. However, records relating to people who did not have capacity to do this, required further review to ensure they were fully in line with best practice. Following our inspection, the provider confirmed that they had carried out a comprehensive review of these records to make sure they accurately reflected how people's rights were being protected.
Risks had been reviewed since the last inspection, but some risks posed by the environment had not been fully assessed and mitigated. The environment was not always suitable for people living with dementia, especially if their condition was likely to deteriorate. We have made a recommendation about creating a suitable dementia friendly environment.
There were enough staff and they were safely recruited. Staff understood their safeguarding responsibilities and knew how to reduce the risk and spread of infection. Medicines continued to be very well managed.
Staff received training and support to carry out their roles and worked well with other healthcare professionals. People’s needs were assessed before they were admitted to the service and their healthcare, eating and drinking needs were well managed.
Staff demonstrated a kind and caring attitude and relationships between staff and those they were caring for were good. There was a warm and homely atmosphere within the service and people told us they felt well cared for. People’s privacy and dignity were maintained.
Care was person centred and care plans contained information about people’s needs and preferences. Activities were varied and people enjoyed them. People’s care needs and preferences for the end of their life had been discussed with them and recorded.
Rating at last inspection and update
The service was rated Inadequate at the last inspection (published 16 August 2019.) At that inspection we found three breaches of regulation. This was because the provider did not have systems set up to safely assess and manage risk and had not ensured people had consented to their care. The inspection before this had also identified the same concerns about safety and risk management. The service remained in Special Measures following that inspection, having been previously placed in Special Measures on 28 September 2018.
Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe.
The rating for this service has now improved to Requires Improvement. During this inspection the service demonstrated to us that sufficient improvements have now been made and the service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor this service and will request an improvement plan to help us do this. We will inspect it again in line with our regulatory inspection schedule, or sooner should we have any concerns.