We carried out a review of the data available to us about Gildawood Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gildawood Court, you can give feedback on this service.
Gildawood Court is a care home, providing personal care and accommodation to up to 60 people. It provides care to older people, some of which are living with dementia. Care is provided across three units, however at the time of our visit, only two units were open. Each unit had its own lounge, garden and dining area with a kitchenette. There was also a large communal dining room. At the time of our inspection 34 people lived at the home.
People’s experience of using this service and what we found
Risk’s to people’s health and well-being had been identified and assessed. However, it wasn’t always clear what immediate actions had been taken to ensure people’s safety with risks associated with their health. Systems were in place to ensure people received their medicines as prescribed. However, some improvements were needed to ensure medicines were always administered safely.
People and relatives were happy with the care provided and the way the home was managed. There was a relaxed atmosphere in the home where we saw many warm and thoughtful interactions between staff and people. People told us they felt safe and protected from the risk of abuse. Records contained information which enabled staff to deliver care in a person-centred way. Staff encouraged people to maintain their independence and make choices about the way in which their care was delivered.
Recruitment procedures were safe and there were enough staff to keep people safe. The provider’s training programme ensured staff had the right knowledge and skills to support and care for people well. People were encouraged to have a healthy and balanced diet. The food looked appetising and people were offered a choice of meal options. Some people required special adaptations in order to eat and drink safely which were known by staff.
People had access to healthcare services when they needed it. Referrals were made to specialists such as dieticians to improve people’s health outcomes and ensure they received targeted support for identified health needs. Daily handovers ensured key information related to people’s health and wellbeing was shared with the staff team.
Assessments were carried about before people moved into the home. Assessments included important information such as current medical conditions and care preferences which helped the registered manager ensure the home could meet the person’s needs.
Staff followed good infection control processes. However, there were some environmental concerns that did not promote good infection control processes. These had been identified by the registered manager and action was being taken to address these concerns following our visit.
People were encouraged to make their own decisions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Systems and processes monitored and improved the quality of care provided and regular checks were completed to ensure people received high quality care. Whilst quality checks had driven improvements in most areas, they had not always identified the shortfalls in some areas. The registered manager was committed to ensuring high quality care and took immediate action to address these issues.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 3 March 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gildawood Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Gildawood Court is a care home, providing personal care and accommodation for up to 60 people. It provides care to older people, all of whom are living with dementia. Care is provided across five units. Each unit has their own lounge, dining area with a kitchenette. There is also a larger, communal dining area. At the time of our inspection visit 35 people lived at the home.
People's experience of using this service and what we found
Risks associated with people's health and care needs were assessed. There had been investment in specialist equipment to mitigate identified risks of falls. However, work to update care plans remained in progress since our last inspection visit. It was not always easy for staff to locate important information in care records and this was acknowledged as ‘work in progress’ by the management team.
Improvement had been made to governance systems to monitor the quality and safety of the service. The management team continued to implement their service improvement plan. Improvements needed to be embedded and sustained to ensure these had the intended outcomes on the care and support provided. The provider continued to work with the local authority to an agreed restriction of two admissions per month.
An 'infection prevention control' audit was carried out by CQC during the inspection. We found the provider was following government guidelines. Improvements had been made to staffing practices, where needed, related to infection prevention and control practices following support from the local authority (LA) and the local clinical commissioning group (CCG) and the registered manager’s direction to staff about expectations.
There were enough staff on shift to meet people's agreed care needs during. However, some staff felt more staff would benefit people’s care, especially at night. Staff were recruited in a way that assessed their suitability to work at the home.
Improvements had been made to the management of medicines. Trained staff supported people to receive their medicines as prescribed.
Overall, people’s relatives spoke positively about the care staff and gave examples of how they were supported to keep in touch with relations during the pandemic and restrictions related to visiting. However, some relatives gave negative feedback and felt communication needed from staff and managers needed to be improved on.
The staff were positive about management changes at the home and felt the registered manager had a positive impact on the care they provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement. (Report published 30 May 2019).
Why we inspected
Prior to our inspection, we (CQC) and the local authority had been undertaking twice monthly video meetings with the provider to support them to drive forward improvements needed at the service. The provider and home management team fully engaged in these meetings and shared their service improvement plan with us.
Following whistle-blowing concerns about infection prevention control management and the safe handling of medicines, the local authority undertook a visit to the home during November 2020. Whilst there had been some improvements since their last check, they found some concerns and found improvements made had not yet been embedded in staff practices. We (CQC) undertook an infection prevention control inspection during November 2020. Overall, we were assured of the provider’s management of infection prevention control. The local Clinical Commissioning Group (CCG) offered support to train staff in infection prevention control. During January 2021, a relative shared their concerns with us about care provided at the home. All these concerns were looked at as part of our inspection.
We undertook a focused inspection to review the key questions of 'Safe' and 'Well-led' only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gildawood Court on our website at www.cqc.org.uk.
At our last inspection we gave a rating of requires improvement and identified breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed numerous action plans after the last inspection to show what they would do and by when to improve.
At this inspection improvements had been made and the provider was no longer in breach of regulations. Further improvements were needed and those made needed to be embedded and sustained. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.
We found the following examples of good practice.
¿ All visitors completed health checks and a Covid-19 screening questionnaire prior to entering the home. Personal protective equipment was available for visitors to use. There was clear information on display in the home to ensure visitors followed guidance and procedures to make sure compliance with infection prevention control.
¿ People were supported to maintain contact with relatives and friends who were important to them through video, social media and telephone calls. The management team had also maintained regular contact with relatives to keep them informed about the wellbeing of their family member.
¿ Staff changed their clothing upon starting and finishing their shifts, to reduce the risk of cross infection. Arrangements were in place for staff to appropriately social distance during breaks and used a separate entrance to access the home.
¿ People were assessed for high temperatures at least twice daily and where symptomatic, were isolated and tested for Covid-19 as soon as possible.
¿ People who had tested positive for Covid-19 self-isolated in line with current guidance; whilst ensuring those people testing negative were kept separate as much as possible for the duration of the isolation period. Clinical waste and laundry were handled in line with government guidance.
Further information is in the detailed findings below.
Gildawood Court is a care home, providing personal care and accommodation for up to 60 people. It provides care to older people, some of whom are living with dementia. Care is provided in five separate units; with the fifth unit on the first floor. Each unit has their own lounge, dining area with a kitchenette. At the time of our inspection visit 56 people lived at the home.
What life is like for people using this service:
• People’s risks to safety and well-being were assessed, recorded and reviewed. However, actions to mitigate risks of harm or injury to people had not always gone far enough to ensure people’s safety was maintained.
• Staffing levels at night were insufficient and meant people were, at times, left unattended on units. Staffing deployment during daytime shifts meant people’s safety was not consistently maintained because communal areas were left unobserved by staff.
• People had their prescribed medicines available to them. However, there had been incidents when people ran out of their medicines because staff had not taken action to ensure there was sufficient stock.
• Overall, staff followed the training they had been given. However, this was inconsistent in, for example, staff's hand hygiene practices.
• Improvement was required in the overall cleanliness of the home.
• People had individual plans of care, so staff had the information they needed to care for them.
• Staff received training, and most were suitably skilled to meet people’s day to day physical needs and protected people from the risks of abuse.
• People, especially those living with advanced dementia, experienced minimal activities and social interaction.
• People had access to healthcare when required.
• Overall, people received enough food and drink to meet their dietary requirements.
• People’s dignity was not consistently promoted by staff.
• People made decisions about their care and were supported by staff who worked within the principles of the Mental Capacity Act 2005.
• The provider’s quality assurance system did not always ensure quality and safety and actions were not always taken to make improvements where needed.
We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:
Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment
Regulation 17 Regulated Activities Regulations 2014 - Governance
Rating at last inspection: At the last inspection the service was rated as Good. (The last report was published on 9 May 2016.
Why we inspected: This was a planned inspection based on the rating of the last inspection. The service is not rated as ‘Requires Improvement’ overall.
Enforcement: Action provider needs to take (refer to end of report).
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Gildawood Court is a care home providing personal care and accommodation for a maximum of 60 older people living with dementia. The home is located in Attleborough within a mile of Nuneaton town centre in the county of Warwickshire. There were 59 people who lived at the home at the time of our visit. All the people at Gildawood Court lived with dementia.
The service had a registered manager. This is a requirement of the provider’s registration. 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. We refer to the registered manager as the manager in the body of this report. We refer to the registered manager as the manager in the body of this report.
People and their relatives told us they felt safe living at the home and staff treated them well. Staff knew how to safeguard people, and were clear about their responsibilities to report safety concerns to the manager. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible; they were safe to work with the people who lived there.
Risks associated with the delivery of care and support for people who lived at the home had been assessed. However, risk management plans and risk assessments had not always been updated when people’s care or support needs changed, and were not always followed by staff. This meant the risks associated with people's care were not always monitored and managed, so that risks to people were minimised. Medicines were managed safely. However systems to ensure medicines were stored correctly were not consistently effective.
New, and existing staff received training which ensured they had the skills and knowledge needed to support people effectively. Staff felt well supported by the management team.
People were supported in line with the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Where people could not make decisions for themselves, people's rights were protected because important decisions were made in their 'best interests' in consultation with health professionals. The provider had made applications to the local authority in accordance with DoLS and the MCA, and at the time of our inspection was awaiting the outcome of some of those applications.
People were encouraged to eat a varied diet that took account of their preferences and specific dietary requirements. People were supported to attend health care appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing.
Staff treated people with respect and dignity, mostly respected people’s privacy. Staff enabled people to maintain their independence. People who lived at the home were encouraged to maintain links with friends and family who could visit the home at any time.
There were enough staff at Gildawood Court to support people safely. Staffing levels enabled some people to have the support they needed to take part in interests and hobbies that met their individual needs and wishes.
People’s care records were mostly reflective of their care and support needs. Where up to date information was lacking, staff demonstrated a good understanding of the needs and preferences of the people they supported. People and their relatives thought staff were caring and kind.
People knew how to make a complaint if they needed to. Complaints received were fully investigated and analysed so that the provider could learn from them. People who lived at the home and their relatives were given the opportunity to share their views about how the service was run.
The provider had established procedures to check the quality and safety of care people received, and to identify where areas needed to be improved. Where concerns were identified, action plans were put in place to rectify these.
The design of the home ensured people had space to move between different areas freely and safely. However, the provider had not utilised the available research which helped services plan their environment to make them more dementia friendly.