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We are carrying out a review of quality at Gloucester House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating


Updated 14 March 2017

Gloucester House is a nursing home that was purpose built in 1990, situated in Sevenoaks, providing en-suite accommodation for up to 54 people some of whom live with dementia.

The service is split in to four units known as villages over two floors connected by a lift and each village accommodates up to 12 to 14 people. The individual villages are named after villages in Kent. There were 45 people in Gloucester House at the time of our inspection.

A registered manager is 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 and associated Regulations about how the service is run.

We carried out an unannounced comprehensive inspection at Gloucester House in March 2016. Breaches of Regulation were found and Gloucester House was rated as requires improvement overall. This was because there were not a sufficient number of suitably trained staff deployed to ensure that people's needs were consistently met to keep them safe. Appropriate assessments of people's mental capacity and best interest meetings were not carried out and documented when necessary. The quality assurance systems needed to be developed to ensure that they identified areas for improvement. We received an action plan from the provider that told us that they were taking action to ensure the health and safety of people who lived at Gloucester House.

This unannounced comprehensive inspection was carried out on the 21 and 24 February 2017 to see if the breaches of regulation had been met. This inspection found that improvements had been made and the breaches of regulation met.

People spoke positively of the home and commented they felt safe. Our own observations and the records we looked at reflected the positive comments people made.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, registered manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance. The provider was actively seeking new staff, nurses and care staff, to ensure there was a sufficient number with the right skills when people moved into the home. The provider had made training and updates mandatory for all staff, including safeguarding people, moving and handling, management of challenging behaviour, pressure area care, falls prevention and dementia care. Staff said the training was very good and helped them to understand people's needs.

All staff had attended safeguarding training. They demonstrated a clear understanding of abuse; they said they would talk to the management or external bodies immediately if they had any concerns, and they had a clear understanding of making referrals to the local authority and CQC. Pre-employment checks for staff were completed, which meant only suitable staff were working in the home. People said they felt comfortable and at ease with staff and relatives felt people were safe.

Care plans reflected people’s assessed level of care needs and care delivery was based on people's preferences. Risk assessments included falls, skin damage, behaviours that distress, nutritional risks including swallowing problems and risk of choking and moving and handling. For example, cushions were in place for those that were susceptible to skin damage and pressure ulcers. The care plans also highlighted health risks such as diabetes and Parkinson’s. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's

Inspection areas



Updated 14 March 2017

Gloucestor House was safe and was meeting the legal requirements that were previously in breach.

There were enough staff to meet people’s individual needs. Staffing arrangements were flexible to provide additional cover when needed, for example during staff sickness or when people’s needs increased.

There were systems in place to make sure risks were assessed and measures put in place where possible to reduce or eliminate risks. Medicines were stored and administered safely.

Comprehensive staff recruitment procedures were followed.

Staff had received training on safeguarding adults and were confident they could recognise abuse and knew how to report it. Visitors were confident that their loved ones were safe and supported by the staff.



Updated 14 March 2017

Gloucestor House was effective and was meeting the legal requirements that were previously in breach.

Staff had a good understanding of people’s care and mental health needs. Staff had received essential training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and demonstrated a sound understanding of the legal requirements.

Staff received training which was appropriate to their job role. This was continually updated so staff had the knowledge to effectively meet people’s needs. They had regular supervisions with their manager, and formal personal development plans, such as annual appraisals.

People were able to make decisions about what they wanted to eat and drink and were supported to stay healthy. They had access to health care professionals for regular check-ups as needed.



Updated 14 March 2017

Gloucestor House was caring. Staff communicated clearly with people in a caring and supportive manner. Staff knew people well and had good relationships with them. People were treated with respect and dignity.

Each person’s care plan was individualised. They included information about what was important to the individual and their preferences for staff support.

Staff interacted positively with people. Staff had built a good rapport with people and they responded well to this.



Updated 14 March 2017

Gloucestor House was responsive. People had access to the complaints procedure. They were able to tell us who they would talk to if they had any worries or concerns.

People were involved in making decisions with support from their relatives or best interest meetings were organised for people who were not able to make informed choices.

People received care which was personalised to reflect their needs, wishes and aspirations. Care records showed that a detailed assessment had taken place and that people were involved in the initial drawing up of their care plan.

The opportunity for social activity and outings was available should people wish to participate.



Updated 14 March 2017

Gloucestor House was well-led. Management was visible within the home and staff felt supported within their roles. Systems were in place to obtain the views of people, visitors and healthcare professionals. The manager was committed to making on-going improvements in care delivery within the home, striving for excellence.

There was an open culture, and people and quality care were at the heart of the service.

Staff were well motivated, worked as a team and wanted to make sure they supported people in a caring and person centred way.

There were systems in place to monitor the quality of the service and any areas for improvement identified were dealt with quickly.