Goldcrest

Updated 25 April 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors.

Service and service type

Goldcrest is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Goldcrest is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

During the inspection we spoke with 6 people living at Goldcrest and 4 relatives. We received feedback from two further relatives. We spent time observing the care and support people received.

We also spoke with the two directors of the provider organisation, one of whom was the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with the newly appointed acting manager and 6 members of the staff team.

We also looked at records related to 7 people’s care, multiple people’s medicines administration records, and records relating to the oversight and management of the service. This included 3 staff files, training records, rotas, internal oversight tools and audits.

Updated 25 April 2023

About the service

Goldcrest is a residential care home providing personal care for up to 26 people. The service provides support to older people living with dementia. At the time of our inspection there were 12 people using the service.

Goldcrest accommodates people in one adapted building in a residential area of Weymouth.

People’s experience of using this service and what we found

We found people were experiencing substantially improved care and support, however further improvements were needed. The oversight of the home had not ensured all issues identified at previous inspections had been addressed.

Goldcrest had recently experienced an unexpected management change. The provider and new acting manager had a plan in place to improve provider oversight and reduce the chance of this happening again. People, their relatives, and stakeholders were being made aware of this change.

Risk management was substantially improved. People were mostly protected from unnecessary risk. Their needs were assessed, their well being was monitored and referrals had been made to health professionals appropriately. However, emerging risk was not always identified and known environmental risks were not being sufficiently managed at the start of our inspection. The provider and the acting manager were responsive and addressed these risks immediately.

The senior team had identified that record keeping was an area for improvement, oversight in place had not been sufficient to ensure enough improvement so that records could be reliably used to support care decisions.

People were supported not to have maximum choice and control of their lives, and staff did not support them in the least restrictive way possible and in their best interests. Whilst people were supported, and encouraged, to make day to day choices and were not restricted within the building, the policies and systems in the service were not supporting people to have maximum choice and control. This was because relatives who held the legal position to speak for their loved ones were not being properly included in decision making.

Recruitment practices had improved, there were, however, some gaps in recruitment records. There were sufficient staff available to meet people’s needs and staff had time to engage with people in meaningful and compassionate ways. Staff training was improved but oversight had not ensured that all staff had kept their training refreshed in line with provider expectations.

People were protected from the risk of abuse as there were systems in place to reduce the risk and staff understood their responsibilities. People described staff as considerate and said they felt safe.

People’s medicines were managed safely. Records confirmed people received their medicines as prescribed.

The environment had been improved and people lived in an environment that they, and their relatives, described as homely. They told us they enjoyed the food.

Staff knew people well, they were positive about their work and felt part of a strong and committed team.

People, and their relatives, were complimentary about staff and of the care provided. People had access to a range of activities and were supported to maintain relationships that were important to them. Staff supported people in ways that reflected their individuality. Staff were kind and respected people’s dignity and privacy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (July 2022). We took enforcement action and the provider completed an action plan after the last inspection to show what they would do and by when to improve. In October 2022 we inspected to follow up on part of this enforcement action. We did not rate the service at this time.

At this inspection we found some improvements had been made and the provider was no longer in breach of some regulations. They also remained in breach of some regulations.

At our last inspection we recommended that the provider review good practice related to adaptive communication. Some improvements in communication had been made.

This service has been in Special Measures since September 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This inspection was carried out to follow up on action we told the provider to take at our last two inspections.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Goldcrest on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management, staffing, the implementation of the MCA and governance at this inspection. As a result of these continued breaches, we have not removed the conditions placed on the provider’s registration following the July 2022 inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.