Archived: Gallions View Care Home

Updated 13 May 2020

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The team consisted of two inspectors, one specialist nursing advisor, and an expert by experience. The expert by experience is a person who has personal experience of caring for an older person living with dementia.

Service and service type: Gallions View is a care home that provides nursing and personal care and support for up to 60 older people. 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.

The service had a manager registered with the Care Quality Commission. 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: This inspection site visit took place on 9 and 10 April 2019 and was unannounced.

What we did: Before the inspection we reviewed information, we had received about the service in the time since our last inspection. This included details about incidents the provider must notify us about, such as allegations of abuse, and serious accidents and incidents. We sought feedback from the local authorities who commission services from the provider, and from professionals who work with the service. Usually the provider is asked to complete a provider information return. This 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. However, on this occasion the provider was not asked to complete a return as we brought the inspection forward due to the concerns we had identified in our monitoring of the service.

During the inspection: We were only able to speak with three people either because other people were unable to communicate with us verbally. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke with four relatives to ask their views about the service. We spoke with six members of staff, the registered manager, quality manager and the area manager. We reviewed records, including the care records of 12 people using the service, recruitment files and training records for three staff members. We also looked at records related to the management of the service such as quality audits, accident and incident records, and policies and procedures.

Updated 13 May 2020

About the service: The home is registered to provide nursing and personal care support for up to 60 older people. At the time of our inspection 40 people were receiving personal care and support from this service across two units.

People’s experience of using this service:

•Care plans and risk assessments were not always updated to reflect changes in people’s care needs. •Risks to people were not always identified and risk management plans were not in place to manage risks safely.

•Monitoring charts, including close observation charts, elimination charts and food and fluid charts were not always completed to help ensure people's safety.

•People's medicines were not always safely managed.

•Incidents were not appropriately logged or investigated to reduce the risk of repeat occurrences.

•Staff were not effectively deployed and were not always aware of their responsibilities. Staff training was not up to date and staff were not always supported through supervisions to ensure they carried out their roles effectively.

•The provider had not followed safe recruitment practices when recruiting new staff.

•People were not always supported and encouraged to eat a healthy and well-balanced diet

•People and their relatives told us and we saw staff were not always kind and did not always respect their privacy, dignity or promote their independence.

•People were not involved in planning their care and support needs.

•People who could not communicate were not provided with information in a format that met their needs.

•The provider’s quality monitoring systems were not effective.

•The registered manager had a lack an understanding of their regulatory responsibilities as they had not reported incidents to the local authority safeguarding team or CQC where required.

•People and staff commented that the registered manager was not visible and did not provide adequate leadership and support.

•People told us they felt safe. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse.

•People were protected from the risk of infection because staff followed appropriate infection control

protocols.

•Assessments were carried out prior to people joining the service to ensure their needs could be met.

•People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

•People had access to healthcare professionals when required to maintain good health.

•People were provided with information about the service when they joined in the form of a 'service user guide' so they were aware of the services and facilities on offer.

•People were aware of the provider’s complaints procedures and knew how to raise a complaint.

•The service was not currently supporting people who were considered end of life but the provider was aware of best practice in this area.

•The provider worked in partnership with the local authority to ensure plans were in place to meet people's.

Rating at last inspection: Inadequate (report published 19 February 2019).

Why we inspected: This inspection was a responsive inspection to follow up concerns we had received about the service.

Enforcement: We found breaches of Regulations in relation to safe care and treatment, person centred care, dignity and respect, staffing, recruitment, good governance and notifications. The majority of which were continued breaches from our previous inspection.

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 continue to monitor the service closely and discuss ongoing concerns with the local authority. The overall rating for this registered provider is 'Inadequate' and the service therefore remains 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.

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