Background to this inspection
Updated
19 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection took place on Thursday 16 June 2016 and was unannounced, which means that neither the home or provider knew we would be visiting.
The inspection team consisted of two adult social care inspectors.
Before commencing the inspection we looked at any information we held about the service. This included any notifications that had been received, any complaints, whistleblowing or safeguarding information sent to CQC and the local authority. We also spoke to the quality assurance and safeguarding's teams at Wigan Council and Wigan Health watch.
During the course of the inspection we spoke to the registered manager and eight staff members, who included team leaders, care assistants and night staff. We also spoke with five people who lived at the home and five visiting relatives.
We looked around the home and viewed a variety of documentation and records. This included: four staff files, six care plans, a policies and procedures file, and four audit files, covering areas such as medicines and infection control.
Updated
19 July 2016
We carried out an unannounced inspection of Garswood House on 16 June 2016.
The last inspection had been carried out on the 10 September 2014 and we did not identify any concerns with the care provided to people living at the home.
Garswood House is a large purpose built home on the outskirts of Ashton in Makerfield and is part of the Croftwood Care Group of homes. It is registered with the Care Quality Commission (CQC) to provide care and support for up to 40 older people. Services include a 10 bed specialist household for older people with dementia and a 30 bed residential unit. Day care and respite are also provided.
The home has three lounges, three smaller quiet sitting areas, a large sun terrace and a large dining room which is also used for various functions.
The home 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. On the day of the inspection the registered manager was on duty and the area manager was also present for some of the time.
Overall we found the home to be clean and tidy, although it was in need of some re-decoration. Both the registered manager and area manager were in agreement with this and plans were in place to carry out this work.
All the people we spoke to told us they felt safe, as did relatives we spoke with. We saw that the home had appropriate safeguarding policies and procedures in place, with detailed instructions on how to report a safeguarding concern to all local authorities who have contracts with the home. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report safeguarding or whistleblowing concerns.
Both the registered manager and staff we spoke to had knowledge and understanding of the mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their own best interest. We saw evidence that DoLS is utilised within the home.
We saw that staffing levels were determined by the needs of the residents, with a dependency tool being used each month to ensure levels remained safe and effective. We saw that the home has sufficient numbers of staff to meet residents needs and the residents agreed with this saying they were well looked after and supported.
Robust recruitment procedures were in place to ensure staff working at the home met the required standards. This involved everyone having a DBS (Disclosure and Baring Service) check, two references and full work history documented.
Staff reported that they received a good level of training to carry out their role and were encouraged and supported to attend more if required. We saw that all staff completed an induction training programme when they first started and that on-going training was provided to ensure skills and knowledge were up to date.
Staff also told us that they felt supported through completion of regular supervision meetings and yearly appraisals. Team meetings were also held for all levels of staff, which they were encouraged to attend and contribute towards.
We saw that the home had systems in place for the safe storage, administration and recording of medicines. Each resident kept their medication in a locked cabinet in their bedroom and only staff authorised to administer medicines were allowed access. All residents taking medicines had a medication administration record (MAR) in place. The home carried out medication audits monthly, and through these had identified some instances of medication not being signed as taken, during the inspection all records we observed were filled out correctly and all medicine amounts tallied.
Throughout the day we observed positive interactions between the staff and people who used the service. Staff were seen to treat people with kindness, dignity and respect. This was mirrored in the feedback we received from both people who used the service and relatives, who were very complimentary about the standard of care provided.
We looked at six care plans which contained detailed information about the people who use the service and how they wished for staff to support them. The care plans also contained individual risk assessments, which helped to ensure their safety was maintained.
Everyone we spoke to felt that the home was both well led and managed. The manager was reported to be approachable and supportive .Staff told us they enjoyed working at the home.
The home had systems in place to monitor the quality of the service. These included audits of staff competency, medication, health and safety, environment and infection control. We saw evidence of action plans being drawn up and implemented to address any issues found.