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Archived: Gracewell of Basingstoke Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 November 2016

This inspection of Gracewell of Basingstoke took place on 20, 21 and 23 June 2016. The home is registered to provide accommodation with personal and nursing care for up to 72 people. At the time of our inspection there were 69 older people living at the home, some of whom were living with dementia.

Accommodation at the home is provided over three floors, which can be accessed using the stairs or passenger lifts. There are five different areas within the home, referred to as communities. Two communities are located on each of the first two floors, with a single community situated on the top floor. There is a large enclosed garden and patio area which provides a secure private leisure area for people living at the home. The home also has a boutique café with internet and computer facilities for people to meet and keep in touch with family and friends. The home contains a purpose built salon to provide hairdressing, manicures and other therapeutic services.

The home did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. The home has not had a registered manager since 31 July 2015, during which time the home has had four interim managers. At the time of our inspection there was a home manager who had been appointed in January 2016, who was in the process of making an application to become the registered manager with the CQC.

The lack of consistent leadership and management had left people, their relatives and staff feeling concerned about the quality of care provided in the home. Staff told us the perpetual change of management had been demoralising and left them feeling as if they were not valued.

The quality of the service had not been consistently monitored by the series of interim managers. The monitoring systems had not identified that care plans did not contain sufficient up to date information to provide people with safe consistent care, that was focussed on meeting their individual needs. The provider had failed to ensure records were completed in a timely manner or to keep records up to date to ensure people received safe care.

There were not enough staff with the appropriate experience and knowledge to meet people’s needs safely. Without exception people, their relatives, friends and staff told us there were far too many agency staff who did not know the people they were supporting. The home’s high dependency on agency staff often meant they did not know people or their needs and people did not recognise staff supporting them.

The home manager had not completed annual appraisals or two monthly supervisions with staff, in accordance with the provider’s policy. Staff had not been enabled to deliver care and treatment to people safely through the provision of effective supervision and appraisals.

Identified risks to people’s health were not always managed by staff to reduce the risk of harm. Although people received the care they required to manage risks to them, some people’s records did not contain all of the required written guidance for staff unfamiliar with people’s risk management requirements to ensure their safety. This increased the risk of people experiencing unsafe or inappropriate care when agency staff were supporting them.

During the inspection several safeguarding concerns were brought to our attention by the provider’s Director of Operations. The provider took the correct action to ensure people were safe whilst the allegations were investigated.

Staff had completed the provider’s required safeguarding training and were able to recognise the different types and signs of abuse. Staff understood their role and responsibility and knew how to report abuse and protect people from h

Inspection areas

Safe

Requires improvement

Updated 4 November 2016

The service was not always safe.

The provider had not ensured that at all times there were sufficient numbers of suitably qualified, skilled and experienced staff to safeguard the health, safety and welfare of people. Without exception people, their relatives , friends and staff told us there were far too many agency staff who did not know the people they were supporting.

Identified risks to people�s health were not always managed by staff safely to reduce the risk of harm to people.

During the inspection several safeguarding concerns were brought to our attention by the provider�s Director of Operations. They took the correct action to ensure people were safe whilst the allegations were investigated.

Staff had undergone robust pre- employment checks as part of their recruitment, to ensure their suitability to support people in the home.

Staff administered people�s medicines safely, in the way people preferred, in accordance with their medicines management plans. Records demonstrated all staff administering medicines had completed relevant training and had their competency to do so assessed.

Effective

Requires improvement

Updated 4 November 2016

The service was not consistently effective.

Staff had not been enabled to deliver care and treatment to people safely through the provision of effective supervision and appraisals.

Staff supported people to make as many decisions as possible.

People were protected from the risks of malnutrition and dehydration. People told us they enjoyed the food and drink prepared. Staff provided appropriate support to enable people to eat and drink at their own pace.

People�s records demonstrated they had seen a variety of healthcare professionals as needed.

Caring

Requires improvement

Updated 4 November 2016

The service was not consistently caring.

Positive caring relationships were not consistently developed by all staff with people living at the home.

People were supported by staff to make day to day decisions that reflected their preferences and recognised their individuality.

Staff were able to explain how they upheld and respected people�s privacy and dignity in the provision of their personal care.

Responsive

Requires improvement

Updated 4 November 2016

The service was not consistently responsive.

People�s care records were not consistently person centred, focussed on the individual, their needs and wishes,

People were not consistently supported to follow their interests or take part in activities of their choice.

Complaints had not always been resolved to the satisfaction of the complainant.

Well-led

Inadequate

Updated 4 November 2016

The service was not well led.

There had been a lack of sufficient permanent clinical leadership to support and supplement the work of the home manager.

The lack of consistent leadership and management had left people, relatives and staff feeling concerned about the quality of care provided in the home.

The quality of the service had not been monitored by the series of interim managers.