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Archived: Gilead House

Overall: Requires improvement read more about inspection ratings

Quality Street, Merstham, Redhill, Surrey, RH1 3BB (01737) 648300

Provided and run by:
Gilead Care Services Ltd

Latest inspection summary

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Background to this inspection

Updated 23 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

¿ Our inspection was completed by two inspectors and an inspection manager who was there to support the inspection.

Service and service type:

¿This service is a care home that provides personal care to older people some of whom are living with dementia. Gilead House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

¿ On the day of the inspection there was a manager that had submitted an application to the Care Quality Commission to be registered. Once registered 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:

¿ Our inspection was unannounced.

¿ The inspection took place on the 29 April 2019.

What we did:

¿Our inspection was informed by evidence we already held about the service including feedback we received from members of the public and local authorities. We checked records held by Companies House.

¿ We reviewed the Provider Information Return. The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

¿ We briefly spoke with two people who used the service and observed care that staff provided to them.

¿ We spoke with the manager and four members of staff.

¿ We reviewed two people's care records, medicine records, audits, recruitment records for three staff and other records about the management of the service.

¿ We requested additional evidence to be sent to us after our inspection that related to policies used at the service. This was received, and the information was used as part of our inspection.

¿After the inspection we spoke with two relatives of people.

Overall inspection

Requires improvement

Updated 23 May 2019

About the service:

Gilead House is registered to provide accommodation and personal care for up to 22 people. There were two people living at the service at the time of our inspection.

People’s experience of using this service:

The recruitment of staff was not robust which left people at risk. Risk assessments were not always up to date or accurate. People’s evacuation plans contained a lack of information about the needs of people. Safeguarding concerns were not always investigated or reported to the Local Authority.

There were however good infection control procedures in place and people received their medicines in a safe way.

Although people’s weights were being monitored, staff were not always aware of the dietary needs of people. People were not always offered snacks in between meals when they said they were hungry. There were aspects to the environment that required improvements.

There were times during the inspection where staff could have been more attentive, caring and dignified towards people. We did see occasions where staff acted in a kind way and relatives fed back that staff were considerate to their loved ones.

Activities needed to be more person centred and outings were not happening as often as people would have liked. Care plans were not always detailed around the needs of people particularly those with health care conditions. End of life care planning needed to be more detailed.

There had been a lack of leadership at the service. The provider had failed to have robust oversight of the service. Quality assurance was not effective in identifying shortfalls. Where shortfalls had been identified there were insufficient actions plans in place to address this.

Staff told us that they felt supported and valued. We saw that they had undertaken training and had one to one discussion with their manager.

Rating at last inspection:

At the last inspection the service was rated Requires Improvement (the report was published on the 5 July 2018). This latest inspection was partly prompted by an incident which had a serious impact on a person using the service and that this indicated potential concerns about the management of risk in the service. While we did not look at the circumstances of the specific incident, which may be subject to criminal investigation, we did look at associated risks.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Prior to the inspection we also received concerns that related to the safety of care at the service. We wanted to follow up on breaches of regulation that were identified at the previous inspection.

Enforcement:

We have identified breaches in relation to the safety of care provided to people, the recruitment of staff, how records are kept and the lack of robust oversight.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Please see the ‘action we have told the provider to take’ section towards the end of the report.