Archived: Gosmore Nursing and Care Centre

Updated 27 January 2016

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 in response to concerns raised and to check whether the 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 20 August 2015 and was unannounced. The inspection team consisted of two inspectors, a specialist advisor with expertise in nursing care for older people and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had experience of caring for an elderly person and a care home environment.

Before the inspection, we reviewed information we held about the service. This included information we had received from the local authority and the provider since the last inspection, including action plans and notifications. A notification is information about important events which the provider is required to send us by law.

During our inspection we spoke with 20 people who used the service. We also spoke with the manager of the home, a senior manager, two nurses, six care staff, an activities coordinator, a chef and a member of the cleaning staff. We reviewed the care and treatment records of 12 people that used the service, five staffing and training records, and records relating to how the provider assessed and monitored the quality of the service provided.

After the inspection we attended a meeting with the provider and other professionals involved with the service to discuss the plans for making improvements to the building and the maintenance of the environment.

Updated 27 January 2016

We undertook an unannounced inspection of Gosmore Nursing and Care Centre on 20 August 2015 in response to concerns that had been raised with us about staffing levels, the quality of care plans and some aspects of care delivery at the service. We also checked whether improvements had been made following our last inspection in February 2015. The home provides accommodation, support and nursing care for up to 63 older people. At the time of our inspection there were 40 people living in the home, some of whom were living with dementia.

The manager who had been newly appointed in February 2015 had completed the process to become the registered manager at the home. 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.

At the last inspection in February 2015 we found the service was not meeting the required standards in relation to the management of medicines and the control and prevention of infection. The provider sent us an action plan to show that they would make the necessary improvements to meet the required standards and stated that they would do this by 29 May 2015. At this inspection we found that the required improvements had been made.

Although there were appropriate numbers of suitably skilled and qualified staff on duty to meet people’s needs on the day of this inspection there had been occasions when the required staffing levels had not been met. The way in which staff were deployed and the layout of the building also had a negative impact on staff’s ability to meet people’s needs.

Staff received on-going training and support and were aware of their responsibilities when providing care and support to people at the service. The manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS), and most assessments had been appropriately completed.

Each person had a support plan in place detailing their needs and preferences. Risks to people were assessed and minimised. However, some people’s plans contained insufficient information and guidance to staff in relation to their specific medical conditions. People were not always supported to eat their meals. However they were supported to access healthcare services as required.

People’s views were sought but not always used effectively to make improvements to the quality of the service.

Audits were used effectively to monitor the quality of the service.

During this inspection we found the service was in breach of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.