Archived: Gosford Lodge

Updated 8 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions in response to concerns raised by the commissioners of services. This inspection was planned to check whether the provider was 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.

This inspection took place on 29 and 30 September 2016. It was an unannounced inspection. This inspection was carried out by two inspectors and a pharmacist.

People living at the home had difficulty communicating verbally with us. We spoke with three relatives and four care staff. We also spoke with the registered manager, the quality manager and the assistant regional director. We also conducted observations around the home to report on people’s experience of the service. In addition we contacted three healthcare professionals and spoke with Oxfordshire County Council (OCC) safeguarding team and the commissioner of services.

We looked at five people’s care records, people’s medicine administration records and four staff files. We also looked at a range of records relating to the management of the service. The methods we used to gather information included pathway tracking, which captures the experiences of a sample of people by following a person’s care route through the service and obtaining their views about their care.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give us key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and notifications we had received. A notification is information about important events which the provider is required to tell us about in law.

Updated 8 November 2016

We undertook an announced inspection of Gosford Lodge on 29 and 30 September 2016.

Gosford Lodge provides accommodation for people who require nursing or personal care, specifically people with learning disabilities or autistic spectrum disorder. On the day of our inspection eight people were living at the service.

There was a registered manager in post. 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.

People’s relatives told us the service was not well managed and they did not have confidence in the service. Senior staff had identified issues within the service and were taking action to address these issues. The provider had spoken to relatives informing them of actions being taken.

The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements. However, these systems were not always effective as they did not identify all of the concerns we identified during this inspection.

Risks associated with people’s health and welfare had been identified and assessed and risk management plans had been written. However, staff did not always follow guidance provided to ensure people’s safety.

People were not always safe from the risk of infection. One person’s room was unclean and presented a risk. We informed the assistant regional director who took immediate action and all the rooms in the home were cleaned.

People did not always receive their medicine as prescribed. Medicine records were not always accurately maintained and medicine audits had not been completed.

There were sufficient staff to meet people’s needs. Staff rotas confirmed planned staffing levels were consistently maintained. However, the right skills mix of staff was not maintained. Some people could not always engage in activities because some staff could not drive.

Staff received appropriate support. Staff supervision (meeting with line manager) was carried out and we saw records for supervisions for September 2016 had been completed.

Staff understood the Mental Capacity Act 2005 (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected. However, where people’s liberties were restricted, measures to ensure restrictions followed the least restrictive practice were not in place.

People were safe from the risk of abuse. Staff understood their responsibilities in relation to safeguarding adults. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People and their relatives had details of how to complain. Recorded complaints had been dealt with in line with the provider’s policy.

People had enough to eat and drink. People could choose what to eat and drink and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.