Archived: Gosford Lodge

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.

Care was planned and delivered in a way that met people's needs. People were complimentary about the care provided. One person told us, 'the staff are fantastic, very kind and make me feel safe'. Another person who could not communicate verbally smiled and gestured with their thumbs up when asked about the care they received. We observed positive interactions between people and care workers.

Appropriate arrangements were in place for the recording of medicines information.

Some people had been prescribed medicines to be given 'when required'; there was always supporting information in place which enabled staff to make decisions as to when to give these medicines in a way that was both safe and consistent.

Medicines were administered directly from where they were stored. Therefore medicines could only be accessed by authorised people. Medicines were handled appropriately. There were systems in place for the obtaining, administering and the disposal of medicines.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke to the relatives of two people, one relative told us 'we've seen them communicate with staff, they use their whole range of communication skills with them'. Another relative said 'I'm really very happy with it.'

We spoke with three members of staff during our visit. Staff were very motivated, caring and positive about working in the home. One member of staff told us 'I love this job, it's very good.'

People were protected from the risk of abuse because appropriate procedures were in place and staff had received training in this area. Staff showed a good understanding of the types of abuse and what their responsibilities were.

People were cared for or supported by suitably qualified, skilled and experienced staff.

The provider had an effective system in place to address any complaints that were received.