About the serviceGildawood 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.