About the service Gingercroft Residential Home is a residential care home providing personal care to up to 21 people. The service provides support to older people and those who may be living with dementia. At the time of our inspection there were 18 people using the service, although one of those people was in hospital at the time of our inspection.
People’s experience of using this service and what we found
People were not always protected from the risk of abuse and incidents were not always identified and reported, as appropriate. However, people told us they felt safe. Staff were not always recruited safely as the appropriate checks were not always completed. There was mixed feedback about staffing levels and staff were not always deployed appropriately. Medicines management needed improving. Risks were not always fully assessed and planned for and there was not always evidence of learning following incidents. Improvements were needed to infection controls practices in the service. Quality assurance systems in place were not effective at monitoring the quality and safety of people’s care. Notifications were not always submitted as required. Staff felt they worked well as a team but did not always feel supported by the provider and registered manager. The registered manager was open to feedback and eager to make improvements.
People’s health needs were not always fully planned for, so staff did not always have detailed guidance. Staff told us they received training, however there were gaps in training records. Areas of the service needed refurbishing as they were in poor condition. A cellar door and open access stairs could pose a risk to people and staff, and this was not always being mitigated.
People were not supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Although we did see staff asking people consent before supporting them.
People were generally satisfied with the food and drinks available and had a choice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 February 2020).
Why we inspected
This inspection was prompted by concerns we received from the local authority about the oversight and safety of the service. A decision was made for us to inspect and examine those risks.
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.
Enforcement
We have identified breaches in relation to people being kept safe from risk, allegations of abuse, appropriate checks not always in place for staff recruitment, getting consent from the relevant person and the oversight of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.