Gingercroft Residential Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider had responded to feedback, both from the CQC and from other professionals, such as the local authority to address concerns and improve care and support to people. Staff were positive about working in the service and enjoyed working there. There were regular team meetings, but more feedback was needed from people and relatives. People and staff were positive about the approachability of the registered manager and deputy manager. However, feedback abut how effective the registered manager was, was mixed. Staff felt there was confusion about the rotas, and this caused issues for them as they were not always effectively managed. Staff felt feedback was raised and it was not always clear action was taken in response to this feedback. The local authority had been monitoring the service and felt improvement had been slow far. However, the service worked in partnership with other professionals and agencies. A new electronic system had been put in place following the last inspection, which had improved the oversight of care. Many new audits had been introduced to improve the effectiveness of the oversight of the service. However, these processes were changing in order to identify the best process for the service, so these were not yet fully embedded or sustained. There were some omissions we identified which had not yet been resolved, but we will check improvements continue the next time we assess the service.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

It was evident there were some tensions between the day team and night team; however, staff remained committed to people’s support and care needs. Staff told us there was a friendly culture and good teamwork in the home. Staff consistently told us the people they were supporting were the most important priority. One staff member commented, “They [the staff team and management] are very friendly and interested in getting the best for the residents.” One staff member said, “I enjoy coming here [to Gingercroft Residential Home]. I look forward to coming here.” Another staff member said, “The home feels homely and like family.” Another staff member told us, “It’s a very nice place to work, all staff and management get on well.” People liked the registered manager. We observed the registered manager was kind and caring when interacting with people. One person told us, “I can’t see a problem with [the registered manager], they are a nice person, they sort things. The deputy [manager] is the same, they are kind.” A professional told us, “The family feel comfortable in contacting the home and this was evident during the assessment as the family had a good rapport with the manager.” The registered manager and deputy manager felt supported by the provider who was in regular touch, both on site and virtually.

There were regular staff meetings to discuss the service and improvements needed. There was a regular focus on a different policy to highlight it to staff.

Staff were positive about the registered manager about their approachability. However, there was mixed feedback about how effective they were as the registered manager. One staff member told us, “The registered manager is approachable, but they don’t follow up on what they say.” Another staff member said, “[The registered manager] is a nice enough person, but I tend to go to [the deputy manager] if I have a concern. I find them both approachable.” It was not always clear what oversight the registered manager had.

Staff were given the opportunity to feedback via surveys and team meetings. However, there was mixed feedback as to whether action was taken in response to feedback.

One staff member told us about having regular team meetings and they are, “Able to make suggestions for improvement.” Another staff member also confirmed there were regular staff meetings and the ability to share ideas. However, there was mixed feedback about whether action was taken in response to feedback. People had also not had regular opportunities to feedback through residents meetings. The registered manager acknowledged there had only been 1 meeting so far.

A staff survey had been completed by the home and staff had fed back about feeling things they had raised did not always get acted on. One comment said ‘management’ were approachable but ‘not acted on though’ and another response said, ‘sometimes things don’t get resolved straight away but they are approachable’. We discussed this with the registered manager and deputy manager and the deputy manager was going to apply to become a registered manager too.

One staff member gave an example where they felt if you did a favour to support the home, this then became expected. No other staff gave us this same feedback. No staff told us they felt treated unfairly.

Some staff felt the rota was not always managed effectively and there were miscommunications leading to confusion among staff, due to duplicate rotas being in use. Having duplicate documents in use is not always an effective process and can lead to issues.

Staff gave us mixed feedback about the amount of improvement in the service since the last inspection. Most felt it had improved, however the speed of the improvement was not fast enough. One staff member said, “I do think its improving. I would have liked it to improve more quickly but they are working on it.” As mentioned, there was also feedback from staff that whilst they felt able to give feedback, they did not always feel this was acted upon. Therefore, we could not always be sure action would be taken.

Following the last inspection, conditions were imposed on the provider's registration, so they had to submit a monthly action plan. The provider was timely in submitting these and responsive to queries. The action plan stated some actions had been completed, which we found to be the case, such as improved safeguarding systems. However, other actions noted as completed, such as the review of everyone’s capacity assessments, still needed improvements which had not been fully recognised by the provider. The majority of audits were being completed by the deputy manager, rather than the registered manager. The deputy manager felt the auditing was now highlighting extra areas for improvements and foundations for quality assurance were now in place. There were plans to start using a new suite of audits from a company providing these which the management team could tailor for the home. Electronic systems had been introduced since the last inspection; the audits were being changed to reflect new ways of working. We saw some completed examples of new audits; some were clear however some were not always clear. For example, an infection control audit noted there was a lack of cleaning schedules in place for pillows, however there was no corresponding action on the action list and the question had been marked as if all was ok. In another example, an environmental health audit was noted as ‘requires improvement’, however there were no omissions or actions identified so it was not clear how this had been arrived at. There were other omissions we found which had not yet been identified in other audits, such as issues with 1 persons capacity assessment and another person’s diet and nutrition information. There were also long gaps in repositioning records. Certain risks with the environment had also not been identified, such as the exposed pipes in a bedroom.

People had involvement from other professionals and organisations when needed.

The local authority had been visiting the service to check the quality and safety of care. Following these visits the local authority gave the provider a list of actions which needed completing. However, the registered manager told us, while they felt a lot of actions had been completed or progress made, the local authority felt the progress was slow.

A professional said, “Following the interactions I have had regarding the resident I am supporting I have been able to approach the manager both face to face and via email and always received consistent communication throughout.” One visiting professional told us they felt staff seemed to know people and felt the home followed their professional advice. Another professional said, “I felt that the manager was aware of the residents situation and had great knowledge and any advice that I provided was considered.” The management team worked in partnership with other organisations and were open to feedback from partners, however, as mentioned, the local authority felt progress to make improvements was slow.

The provider and management team engaged in meetings with the local authority and other professionals. The provider also complied with the conditions imposed on their registration, as required. People were on the improvement journey with the management team and provider. Feedback from visiting professionals had been welcomed and the provider recognised the improvements were needed.

One staff member said the service had ‘slightly improved’. Another staff member told us things were ‘changing’ and ‘improving’ in the home. One staff member told us, “We have more time to care and [spend] less time on paperwork. Digital records have made a big improvements.” The provider had embraced the use of technology to try and improve information and care to people. The electronic system allowed a greater oversight as managers had access to the systems in real time. However, further improvements were needed to the quality of information on the electronic systems and to ensure the daily records were up to date. While improvements were in progress, these had not yet been fully embedded, and the provider was still trying out new ways of monitoring the service.

We saw action was taken in response to complaints and responses were sent to people or relatives where necessary. There were multiple concerns and breaches of regulation identified at the last inspection. The provider and management team had worked to make changes and improvements to the service to resolve issues. While we still found areas for improvement at this assessment, the risk to people had reduced and work was ongoing to continue this improvement. We will check improvements continued and were sustained at the next assessment.