Archived: Gresham Lodge Care Home

Updated 15 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 13 October 2015 and was unannounced. The first day of the inspection was undertaken by a social care inspector with an expert by experience. The second day the inspector visited by themselves. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection we looked at the notifications on file and reviewed all the intelligence the Care Quality Commission [CQC] had received to help inform us about the risk level for this service. This information was reviewed to help us make a judgement. We spoke with the local authority and their safeguarding team prior to our visit regarding this service. There were no concerns raised.

We used a number of different methods to help us understand the experiences of the people who used the service. A Short Observational Framework for Inspection [SOFI] was used to help us understand the experiences of people who used the service who were unable to tell us their views.

During our inspection we undertook a tour of the building. We observed how people were treated in the communal areas of the service. We inspected the medicine systems in place. We watched lunch and tea being served. We looked at a variety of records; this included three people’s care and medicine records. We looked at records relating to the management of the service; policies and procedures, maintenance records, quality assurance documentation and complaints information. We also looked at staff rotas, three staff files, training and supervision records and information about recruitment. We found some minor environmental issues needed to be addressed; the shower room required cleaning and a commode required cleaning and a shower chair was replaced.

We spoke with the registered provider and deputy manager, five staff and the cook. People living at the service were spoken with in general and we interviewed eight people in detail. We gained the views of five relatives. We asked six visiting health care professional for their views about the service. The feedback we received was positive. 

Updated 15 December 2015

This inspection was undertaken on 12 and 13 October 2015 and was unannounced.

Gresham Lodge Care Home is registered with the Care Quality Commission [CQC] to provide accommodation and personal care for up to 21 older people some of whom are living with dementia. The service’s communal areas are situated on the ground floor with bedrooms located on the ground and first floor. There is a car park for visitors to use. Staff are available 24 hours a day to support people.

This service has a registered manager in place. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood how to protect people from harm and abuse. They knew how to report abuse and told us they would report issues to the manager and the local authority, or directly to the Care Quality Commission.

Staffing levels observed during our inspections met people’s needs. Recruitment processes in place protected people from staff who may not be suitable to work in the care industry.

People’s care records reflected their full and current needs. Staff understood people’s needs and were aware of potential risks to their health and wellbeing. Staff placed their emphasis on providing effective care and support to people.

Training was provided for staff in a variety of subjects, supervision was in place and appraisals were scheduled. This helped to support staff and maintain their skills.

People were provided with home cooked food. Meal times were social occasions. People’s food and fluid intake was monitored, where this was necessary to maintain their health and wellbeing. People were prompted or assisted with meals and drinks by patient and attentive staff to ensure their dietary needs were met.

Visiting health care professionals told us that staff contacted them in a timely way and acted upon their advice to promote people’s wellbeing.

Pictorial signage was in place throughout the service which helped people find their way around. People’s bedrooms were personalised to their needs. Refurbishment plans had been completed downstairs. Some further work was to be carried out at a later stage to the rooms upstairs to improve these facilities. The building was maintained and service contracts were in place.

Staff respected people’s privacy and dignity. People made decisions about how they wished to spend their time. Staff asked people about the support they wanted to receive and acted upon what they said. There was an extensive programme of activities and outings available to people.

We found the registered provider usually worked within the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS] with regards to making applications to the local authority when people who lacked capacity were deprived of their liberty. However, we found one person who lacked a capacity had been cared for in bed when they were not able to consent to this, and that the general MCA principles were not followed in this case. There were other instances when MCA principles were followed for people which meant there was a lack of consistency by the registered provider, in this case. The recording of some decisions made in people’s best interest could be improved. This issue was addressed straight away at the time of our inspection.

There was a complaints procedure in place. The registered manager undertook regular audits covering all aspects of the service. The management team reviewed the service provided regularly to help them to develop or improve the service provided. We have made a recommendation in this report for the registered provider to ensure applications are sent timely to the local authority in relation to Deprivation of Liberty Safeguards.