207 Goodmayes Lane

207 Goodmayes Lane is a residential care home providing the regulated activity of personal care to up to 6 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 2 people using the service. The home is an ordinary house in a residential street.

People’s experience of using this service and what we found

Risks to people were not always adequately assessed. The provider did not have effective systems in place to mitigate the risk of financial abuse. Care plans were not comprehensive as they did not cover equality and diversity needs or end of life care. Quality assurance systems were in place, but these were not always effective. Records were not maintained of staff supervision and we have made a recommendation about this.

Medicines were managed in a safe way, although we have made recommendation about the management of controlled drugs.

Systems were in place to protect against the spread of infection. Staff were aware of their responsibility to report allegations of abuse. People told us they felt safe using the service. Checks were made to help ensure the premises were safe. There were enough staff working at the service and robust staff recruitment practices were followed.

People’s needs were assessed before they moved into the service. Staff received training to help them in their role. People were able to choose what they ate and drank and the got enough to eat. The premises were well maintained and homely in appearance. Staff supported people to access health care services.

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.

People told us that staff were kind and caring and treated them well. People were supported

to have control and choice over their daily lives. People's privacy was respected, and staff understood the importance of maintaining confidentiality.

Care plans were in place which set out how to meet the individual needs of people, with the exception of equality and diversity needs and end of life care. People and relatives were involved in developing these plans, which meant they were able to reflect people's needs and preferences. People's communication needs were met. People told us they had confidence that any complaints raised would be addressed. People were supported to take part in activities and to maintain relationships with family and friends.

There was an open and positive culture at the service, which meant people, relatives and staff could express their views. The provider worked with other agencies to develop best practice and share knowledge.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

At the last inspection [published 27 May 2022] we did not give an overall rating, as we only looked at the Safe and Well-led questions in full. Both of these questions were rated as Inadequate. At this inspection the overall rating is Requires improvement.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last inspection, by selecting the ‘all reports’ link for 207 Goodmayes Lane on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to systems for safeguarding people from the risk of financial abuse, risk assessments about individual risks people faced, care plans and quality assurance systems at this inspection. We have also made recommendations about medicines management and staff supervision.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

207 Goodmayes Lane (Gwendoline Caring Home) is a care home in the London Borough of Redbridge. They are registered to provide personal care for up to six people with dementia, older people and younger people. At the time of the inspection two people were living at the service.

People’s experience of using this service and what we found

Medicines were not being managed safely. They were not always stored securely, and we found gaps in their administration. There was no system in place to check whether people had their medicines administered correctly. Risks to people were not always assessed. People had serious health conditions and there was a lack of information for staff about those conditions. Lessons were not learned when things went wrong. Incident recording was poor. Staff were not recruited safely. References were not recorded sufficiently well and criminal records checks on some staff had not been done until we inspected. People were not safeguarded from abuse as staff had not been trained to recognise the signs of abuse.

There were infection prevention control measures in place.

The provider was unable to satisfactorily evidence staff induction or training. The provider had not taught staff a consistent way to work in areas such as administration of medicines, safeguarding adults from abuse, infection control or basic life support. This meant people were not being cared for safely as the provider had not assured themselves of staff knowledge. The provider was unable to clearly evidence staff had received an induction or training.

The service was not well led. Governance and administration practices were poor. Some documents were unable to be found at the time of asking, though some were provided later. Quality assurance measures were not always accurate. No evidence of engaging with people and staff through regular meetings was provided. The service was not fully utilising local adult social care networks which could benefit people living at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 18 March 2021 and this is the first inspection.

Why we inspected

We undertook a targeted inspection to look at infection prevention control. 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. This included checking the provider was meeting COVID-19 vaccination requirements

We inspected and found there was a concern with the state of the premises and the quality of documentation provided to us, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

We have found evidence that the provider needed to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, staffing, safeguarding people from abuse, good governance and fit and proper persons employed at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.