Background to this inspection
Updated
27 February 2021
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.
As part of CQC's response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.
This inspection took place on 17 February 2021 and was announced.
Updated
27 February 2021
We carried out an inspection of Garswood House Residential Care Home on the 24 and 25 October 2018, the first day of inspection was unannounced. This was the first time the home had been inspected since it re-registered with the Care Quality Commission in November 2017, due to a change in ownership.
Garswood House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Garswood House is a large purpose-built home on the outskirts of Ashton in Makerfield. It is registered to provide care and support for up to 40 older people. Services include a 10 bed specialist household for older people living with dementia and a 30 bed residential unit. Day care and respite are also provided. At the time of inspection 38 people were living at the home.
The service 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.
The home had a clear management structure in place with the registered manager being supported by a deputy manager. The home was further supported by the area manager and provider’s compliance manager, who were regular visitors to the home. Staff told us the registered manager was a visible presence in the home and was “always happy to help out.”
People living at the home told us they felt safe and well cared for. Relatives we spoke with also had no concerns about the safety of their family members and spoke positively about the standard of care provided. We found staffing levels were sufficient to meet people’s needs and keep them safe.
The home had appropriate safeguarding policies and procedures in place, with instructions on how to report safeguarding concerns to each of the local authorities who commissioned services from them. Staff had received training in safeguarding vulnerable adults and demonstrated a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.
The home was clean, free from odours with effective infection control procedures in place. Hand hygiene guidance and equipment was located in bathrooms and toilets and personal protective equipment (PPE) such as gloves and aprons were available for staff to use to help prevent the spread of infections.
We found medicines were stored, handled and administered safely and effectively. Staff who administered medicines had received training and had their competency assessed. Medication Administration Record (MAR) charts had been completed correctly, as had topical medicine charts, which are used to record the administration of creams and lotions. We found guidance for ‘as required’ (PRN) medicines such as paracetamol were in place, to ensure people were given these medicines safely and when needed.
The staff we spoke with displayed a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We found the home was adhering to the principles of the MCA. DoLS applications had been submitted appropriately for people deemed to lack capacity to consent to their care and treatment. We saw best interest meetings had been conducted to support decision making where people lacked capacity to make these decisions and had no legal representative to do so.
Staff spoke positively about the training provided. Training completion was monitored and promoted, to ensure staff’s skills and knowledge remained up to date. Staff told us they received regular supervision and annual appraisals, which along with the completion of quarterly team meetings, ensured they were supported in their roles.
People told us they received enough to eat and drink and were happy with the choice of meals offered. Specific dietary needs, such as soft or pureed meals and/or thickened fluids, had been supplied in line with guidance.
Throughout the inspection we saw positive interactions between staff and people living at the home. People and their relatives told us staff were kind, caring and considerate, which was noted in the exchanges we observed. Staff clearly knew the people they supported, who in turn were comfortable in staff’s presence.
As part of the inspection, we looked at five care files which contained detailed information about each person and how they wished to be cared for. Each file contained detailed care plans and risk assessments, which helped ensure people’s needs were being met and their safety maintained.
People’s views were sought and they were actively involved in the home. Regular resident meetings were held and newsletters produced to ensure information was communicated clearly. People were involved in staff interviews and recruitment, to ensure they had a say in who supported them.
The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed both internally and at provider level, with action plans and checklists completed to ensure improvements were made.