Garswood

Updated 13 October 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 2nd September 2021 and was announced.

Updated 13 October 2021

This unannounced comprehensive inspection took place on 18 December 2017.

At the previous inspection we found breaches of regulation in relation to; the safe administration of medicines, governance, safe recruitment and staff support. As part of this inspection we checked to see if the necessary improvements had been made and sustained. The service was now meeting regulatory requirements.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; Safe, Effective and Well-led to at least good. We found that improvements had been made in accordance with the action plan in each of the key questions.

Garswood is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Garswood is located in Southport close to public transport links and Birkdale village. Accommodation is arranged over four floors with lift access to each floor. The home is registered to accommodate 39 people and includes a dedicated unit (Hazelwood) to accommodate seven people who are living with dementia. At the time of the inspection 22 people were living in the main building with a further seven in Hazelwood.

A registered manager was in post. 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 observed a member of staff while they administered some medicines and checked records, storage arrangements, stocks and audits. The medication policy was comprehensive and audits had been effective in identifying errors. The provider was no longer in breach of regulation 12 with regards to the safe administration of medicines.

We checked four recruitment files and found that they reflected safe recruitment practice. Each file contained an application form with a detailed employment history, photographic identification, references and evidence of a DBS check. The provider was no longer in breach of regulation 19 regarding the recruitment of fit and proper persons.

The majority of supervision and appraisals had been completed in accordance with the provider’s schedule. Where meetings had not taken place the reason was recorded and alternative dates had been entered onto an electronic record. Staff told us that they were well supported by the management team and could request additional support through informal or formal supervision as required. The provider was no longer in breach of regulation 18 regarding staff support.

During this inspection we saw evidence of regular audits being conducted and action taken when issues were identified. Audits looked at a full range of relevant areas such as; health and safety, MCA/DoLS status, medicines, welfare, maintenance and activities. The provider was no longer in breach of regulation 17 regarding quality assurance processes.

The staff that we spoke with were able to explain how they helped to keep people safe and safeguard them from potential abuse. Information about safeguarding was clearly displayed within Garswood and the staff we spoke with were able to explain their responsibilities to report concerns both internally and externally (whistleblowing) if required. Individual risk was appropriately assessed and reviewed to ensure that people were kept safe without unnecessarily restricting their independence.

Garswood had a robust approach to the recording and monitoring of incidents and accidents. The records that we saw were detailed and showed evidence of review and analysis by the registered manager.

The home was operating in accordance with the principles of the Mental Capacity Act 2005 (MCA). Applications to deprive people of their liberty had been submitted appropriately.

People spoke very positively about the food at Garswood and were supported to maintain a healthy diet. They were supported by staff to access healthcare services in a timely manner.

People spoke positively about the quality of care they received and the attitude of the staff and managers. Throughout the inspection we observed that staff were vigilant in monitoring people and provided care in a timely and respectful manner. They spoke to people with a clear understanding of their histories, preferences and needs and used gentle re-assuring language when people were confused or distressed.

Garswood utilised a range of methods to encourage people to express their views. We saw evidence in records which indicated that staff had listened to and acted on people’s comments.

People had access to lounges and other rooms if they needed privacy to meet with friends or relatives. Each person also had en-suite facilities with a shower for the provision of personal care although they could choose to use an accessible shared bathroom if they wanted a bath. We also saw that most people had locks on their bedroom doors.

Garswood ensured that people received personalised care that met their needs. We saw that care records had been produced with the involvement of the person and their relatives and were subject to regular review. Care records contained extensive information about people’s personal histories, families, care needs and preferences. Care records were respectfully worded and showed clear evidence of review and development when people’s needs changed.

The home employed two coordinators who organised individual and group activities. We saw evidence that they had worked with people to record their histories and preferences and reflect the information in creative ways. We saw evidence of individual activity programmes including; painting and gardening. We also saw an extensive range of group activities took place including; bingo, quizzes and trips-out.

Garswood is run by Christadelphian Care Homes and primarily provides care and accommodation for people of that faith. However, other faiths were recognised and fully accommodated by the home.

Staff recognised the need to communicate with people on an individual basis. This individualised approach to the provision of information ensured that Garswood met the Accessible Information Standard.

When we checked the record of complaints we found that only one had been received in 2017. This had been addressed promptly and professionally in accordance with the provider’s policy.

Staff and managers were conscious of the need to support people and their wishes at the end of their life. We saw and heard examples of how end of life care was planned for in conjunction with the person, their family and healthcare professionals.

Garswood had an extensive and clear management structure with a focus on people’s experience of care and the provision of support to maintain healthy, stimulating, independent lives.

Throughout the inspection the staff and managers were open and responsive. They were able to provide evidence on request and clearly understood management systems and what was required of them.

The home demonstrated a commitment to continuous learning and development by supporting staff to access learning opportunities and through attendance at local and national events which promoted innovation and best-practice.