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Archived: Golborne House Residential Care Home Good

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Reports


Inspection carried out on 8 March 2017

During a routine inspection

This inspection took place on 08 March 2017 and was unannounced.

Golborne House is located in Golborne, Greater Manchester and is part of Croftwood Care which is owned by Minster Care Group. The home is registered with the Care Quality Commission (CQC) to provide care for up to 40 older people. The home provides care to those with residential care needs, many of whom are living with a diagnosis of dementia.

At the time of our inspection there were 35 people living at Golborne House.

At our last inspection on 13 May 2016, the service was rated Good. At this inspection we found the service remained Good.

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The service had a registered manager. 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.

People told us they felt safe living at Golborne House. Staff received safeguarding training and knew how to keep people safe and raise concerns if they suspected someone was at risk of harm or abuse.

People had comprehensive risk assessments which were reviewed and updated timely to meet people’s changing needs. This ensured staff had access to the relevant information and guidance to mitigate risks.

Staffing levels were based on the dependency of people living at the home. People, relatives and staff told us, there were sufficient numbers of staff on duty to meet people’s needs.

The management of medicines was safe. There were appropriate arrangements in place to ensure that medicines had been ordered, stored, received and administered appropriately.

The service had a training matrix to monitor the training requirements of staff. Staff received appropriate training, supervision and appraisal to support them in their role.

People were supported in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged to make decisions and choices about their care and had their choices respected.

People's consent to care and treatment was sought prior to care being delivered.

People were encouraged to maintain a healthy nutritionally balanced diet and had access to sufficient amounts to eat and drink, at times that suited them. People's health care needs were monitored and maintained; people had access to health care services as and when needed.

People continued to receive care and support from staff that were kind, caring and compassionate.

People were treated with dignity and respect and had their independence promoted by staff that openly expressed their fondness for the people they cared for and supported.

Care plans were person centred and tailored to meet people's individual needs. People were encouraged to be involved in the development of their care plans, which were updated regularly to reflect people's changing needs.

A variety of activities were provided and staff demonstrated a good understanding of people’s needs and adapted activities to reflect people’s individual interests.

The provider had a complaints procedure in place and people felt confident in raising concerns or complaints to staff and the registered manager.

The registered manager and provider carried out regular audits of the home. We saw areas of improvement were identified and disseminated promptly throughout the staff team to demonstrate action had been taken in a timely manner. Feedback of the home was sought and used to drive continued improvements.

Inspection carried out on 13 May 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 23 and 24 September 2015. At which time, we identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to Safe Care and Treatment, Good Governance and Staffing. As a result, we issued a warning notice and two requirement notices due to the concerns we had identified.

After the comprehensive inspection, the registered manager sent us an action plan, detailing what they were going to do to meet the legal requirements in relation to the breaches we had identified.

We undertook an unannounced focused inspection on the 13 May 2016 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to the identified breaches. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Golborne House Residential Care Home’ on our website at www.cqc.org.uk’

Golborne House is located in Golborne, Greater Manchester and is part of Croftwood Care which is owned by Minster Care Group. The home is registered with the Care Quality Commission (CQC) to provide care for up to 40 people. The home provides care to those with residential care needs, many of whom are living with dementia.

At the time of our focused inspection there were 36 people living at Golborne House.

There was a registered manager in post and they were on duty when we visited Golborne House. 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.

At our focused inspection on the 13 May 2016, we found that the registered manager had followed their plan which they had told us would be completed by the 31 January 2016 and the legal requirements had been met.

All the staff we spoke with informed us that falls management had significantly improved at the home since our last inspection. We saw a board had been put up on the wall in the care team leader’s office that identified people at risk of falls and indicated hourly observations had to be conducted.

Staff told us they were more vigilant regarding preventative measures that they could follow to reduce the risk of incidents occurring. Staff completed incident forms capturing as much information as possible surrounding the incident. The care team leader then completed a Falls Risk Assessment Tool (FRAT). The FRAT was completed on all people who used the service who had experienced a fall and had guidance notes attached for staff detailing what action to take.

We found falls were robustly managed. We saw the registered manager had completed a falls, slips and trips investigation following each person having a fall, slip or trip. Two fall’s champions had been introduced since our previous inspection that met with the registered manager and disseminated information to the wider staff team. The registered manager completed a falls matrix and this was audited by the area manager monthly to ensure all actions had been taken to mitigate risks.

Staffing numbers were calculated based on people’s dependency and during this inspection we saw that there was more staff on duty. We observed staff were more vigilant and responsive to people’s needs. Staff spoke positively about the changes since our previous inspection and felt that there had been significant improvements to the care that people received.

We saw that systems had been implemented to support staff complete documentation and staff vocalised feeling accountable for maintaining accurate records.

Inspection carried out on 23 & 24 September 2015

During a routine inspection

This comprehensive inspection was unannounced and was conducted on 23 and 24 September 2015.

Golborne House is located in Golborne, Greater Manchester and is owned by the Minster Care Group. The home is registered with the Care Quality Commission (CQC) to provide care for up to 40 people. The home provides care to those with residential care needs, many of whom live with a diagnosis of dementia.

Golborne House is a two storey building and people’s bedrooms are located on both the ground and first floors of the building. All rooms are of single occupancy. However, shared accommodation can be arranged, if required. There are two lounge areas on the ground floor and a dining room. On the second floor, there is a quiet lounge with a kitchen and a hairdressing room. There are seven toilet facilities on the ground floor, eight on the second and assisted bathing facilities on each floor. Car parking is available at the home, as well as in side streets close by.

At the time of our inspection 39 people were living at Golborne House. We last inspected this location on 07 July 2014, when we found the service to be compliant with all regulations we assessed at that time.

The registered manager was on duty when we visited Golborne House. 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 of the Health and Social Care Act and associated regulations about how the service is run.

During this inspection, we identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to Safe Care and Treatment, Good Governance and Staffing. We are considering our enforcement options at this stage.

You can see what action we told the provider to take at the back of the full version of this report.

People told us they felt safe living at Golborne House, but we found shortfalls in the management of slips and falls. Although incidents were reported and falls were reported robustly, no full action was documented and no plans were implemented to mitigate the risk of further incidents.

This was a breach of Regulation 12 (1)(2)(a) (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People, and their relatives, who we spoke with did not raise any concerns about their safety or that of their family member. However, people did raise concerns about staffing levels and that there was not enough staff to meet people’s needs. We found there were not sufficient numbers of staff deployed at all times to meet people’s needs. We were told by two healh professionals that there was a high proportion of people at the home with moisture lesions and skin tears. We also observed on the day of the inspection that people didn’t have their teeth or hearing aids in which we felt was a consequence of staff being rushed as a result of the staffing level.

This was a breach of Regulation 18 (1) of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Staff knew how to keep people safe and how to raise any concerns if they suspected someone was at risk of harm or abuse. Staff understood the risks people could face through everyday living and how they needed to ensure their safety.

The management of medications, in general promoted people’s safety. Medication records were well maintained and detailed policies and procedures were in place.

New staff were suitably checked and vetted before they were employed. However, we found four staff that had worked at the home for a long time but there was no Disclosure and Barring (DBS) check record documented in there file. We were told that this was a historical issue with the previous provider holding these records. The registered manager promptly resolved this by requesting new DBS checks to be completed.

People had a choice of meals, snacks and drinks, which they told us they enjoyed. There was flexibility in what people might want to eat and when.

On the second day of the inspection there was a vibrant atmosphere in the home. A variety of activities were provided and staff demonstrated a good understanding of people’s needs and adapted activies to reflect people’s individual interests.

We observed people were treated with dignity and respect. Throughout the inspection we saw staff engaging with people in a positive and caring manner. Staff spoke to people in a respectful way and used language, pace and tone that was appropriate to the individual. Staff took time to listen to people and responded to comments and requests. People felt staff were kind and respectful to them.

Staff members were well trained and those we spoke with told us they had access to training programmes and provided us with some good examples of modules they had completed. We noted that there was a high attainment of vocational qualifications amongst staff. Staff also confirmed that regular supervision sessions were conducted, as well as annual appraisals and we saw documentation to substantiate this.

The registered manager and staff were aware of their responsibilities around legislation regarding people’s mental capacity. Staff described how they obtained people’s consent before delivering care.

People knew how to make a complaint and these were responded to within the timescales of the provider’s policy. Staff felt able to raise concerns or issues with the registered manager.

Although there were systems to assess the quality of the service provided in the home, we found that these were not always effective. The systems had not ensured that people were protected against risks. We found that the audit system had not identified the risk to people around slips and falls, or picked up that there were gaps in the documentation and that there were insufficient staff deployed to meet people’s care needs.

This was in breach of regulation 17(1)(2)(a)(b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.