Goodwood Orchard Care Home

Goodwood Orchard Care Home is a residential care home providing personal and nursing care for up to 21 people. The service supports older people, including those living with dementia. At the time of the inspection visit, 20 people were living in the service.

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

Arrangements for assessing risk and safety monitoring were not always robust, as a number of issues with the environment were identified during the inspection visit. The registered manager took action immediately following the inspection to rectify all of these issues.

People who used the service told us they felt safe and happy. They told us staff treated them well and they knew who the manager was. Staff had a good understanding of safeguarding, and how and who to report concerns to. Staff had a good level of knowledge of people's needs, and how they cared and supported people.

Infection control measures had been increased since COVID-19 and the registered manager had worked hard to ensure people remained safe. However, some hygiene issues were identified during the inspection, which were rectified swiftly by the registered manager.

People and relatives' spoke positively of the care and communication they had received during COVID-19.

The registered manager had quality monitoring systems in place which reviewed incidents and looked at patterns. This was helpful to identify trends, or key times when people may need additional support.

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

Rating at last inspection

The last rating for this service was good (published 12 December 2019). At this inspection we found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

Why we inspected

We received concerns in relation to restrictive practices when supporting people who become distressed. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

The registered manager took immediate action following the inspection to mitigate the concerns found by the inspectors at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Goodwood Orchard Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return. If we receive any concerning information we may inspect sooner.

Goodwood Orchard Care Home is a residential care home providing personal and nursing care for up to 21 people. The service supports older people including those living with dementia. At the time of the inspection visit 18 people were using the service.

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

At our last inspection we found risks to people were not effectively monitored and the medicines recording, and storage system was not robust. Although people’s health and safety was not put at risk, improvements were needed to prevent potential risks of harm to people.

At this inspection we found the provider had made improvements to promote people’s safety. Risks to people were assessed, managed and monitored. Support plans provided clear guidance for staff to follow to meet people’s needs and to keep them safe. People received their medicines in a safe way. Medicines were stored safely.

People enjoyed the choice of food and drinks. People enjoyed their meals and the atmosphere in the dining room was friendly and sociable. Staff assisted people to eat their meals in a caring way.

People had access to a range of health care services. Staff sought medical advice and support to meet people’s ongoing health needs. Procedures were followed to ensure people had the opportunity to express their wishes in relation to end of life care.

People lived in a clean and tidy environment. People had personalised their rooms. The lounges and some bedrooms had been decorated. The provider continued to make improvements to the premises, decoration to benefit people living with dementia and sensory impairment and had plans to create a private office / meeting room.

Staff recruitment procedures were followed to protect people from unsuitable staff. There were enough staff to meet the needs of people. Staffing levels were monitored and managed. Staff were trained, had the knowledge and skills they needed to support people safely and effectively. Staff practices were monitored and were supervised regularly.

Staff sought people’s consent and respected their decisions. 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 continued to receive responsive and person-centred care. People were involved in the assessment and care planning process, so they would be supported in the way they wanted. Support plans were being updated to include personalised information such as people’s preferred toiletries and the music they enjoyed.

Staff were kind, caring and had established meaningful relationships. Staff were committed to non-discriminatory practices and to providing quality care. People’s privacy and dignity was respected, and their independence was promoted by staff. We saw people looked relaxed and comfortable and they enjoyed a range of meaningful activities of interest to them. People received visits from family and friends. People’s religious and spiritual needs were met.

People knew how to complain and were confident complaints would be taken seriously. Records demonstrated all complaints were investigated and action was taken as needed. Systems were in place to ensure the views of people, their relatives, staff and professionals were sought to help develop the service.

At our last inspections further improvements were needed to ensure the service was well-led. The service had a registered manager who understood their legal responsibilities. The provider’s quality assurance systems and processes were being used effectively to monitor the quality of the service and to drive improvements. Everyone we spoke with felt the registered manager was responsive and approachable. Any lessons learnt when things went wrong was shared with staff. The registered manager was responsive and addressed issues identified during this inspection.

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

Rating at last inspection

The last rating for this service was requires improvement (published 21 November 2018). At this inspection we found improvements had been made and had been rated as good.

Why we inspected

This was a planned inspection based on the previous rating. The inspection was prompted in part due to concerns received about the quality of care provided, staffing, staff training, and the management of the service. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Goodwood Orchard Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Goodwood Orchard Care Home 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.

Goodwood Orchard Care Home provides accommodation for up to 18 people in one adapted building. The service specialises in caring for older people including those with living with dementia. At the time of our inspection 17 people were in residence.

This was the first inspection of the service since they were registered in March 2018. At this inspection we found evidence to support the rating of ‘requires improvement’.

A registered manager was not in post. The provider had appointed a manager and they had begun the registration process. 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 will continue to monitor this.

The risks to people’s health and wellbeing had been assessed. However, further improvements were needed to ensure risks were reviewed when people’s needs changed and care plans were updated to provide clearer guidance for staff to follow.

People and their family were involved in the development of their care plans, but their decisions were not always documented or showed that people had been involved in the review of their care. The new care plans and risk assessments developed were comprehensive and reflected people’s needs, preferences and diverse cultural requirements. A system was put in place to review risks to people and information transferred to the new care plan formats provided clear guidance for staff to follow. The provider assured us they would monitor this.

People received their medicines in a safe way. However, further action was needed to ensure staff followed the safer management and administration of people’s medicines in relation to medicines that had only 28 days shelf life and to complete medicines administration records in full.

The provider had governance systems and processes had not been fully implemented. The provider’s policies and procedures were being reviewed and updated. There were arrangements in place to ensure actions were taken and lessons learned when things went wrong, to improve safety across the service. The provider agreed to reflect and develop their systems further that would ensure improvements would be maintained.

The provider had made some improvements to the premises and décor and purchased new equipment and furniture as needed. The provider made improvements immediately where safety issues were found in relation to the premises and equipment.

People lived in an environment that was clean and tidy. Staff followed infection prevention and control practices.

Staff recruitment procedures reduced the risks of employing staff unsuitable to work in care. There were enough staff to meet people's needs. Staff were trained in safeguarding and other safety procedures to ensure people were safe and protected from avoidable harm. Staff were supported in their role and received training and supervision to provide effective care. Staff understood their responsibilities to report concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved and made decisions about all aspects of their care. Although decisions made were not always documented staff acted on and respected people’s wishes.

People were provided with choice of meals that met their dietary needs. Drinks and snacks were readily available. People had access to health care services as needed to maintain good health.

People were cared for by kind and caring staff. People’s dignity and privacy was maintained. People had the opportunity make decisions about their end of life care.

People to receive care that was responsive and personalised. Staff were aware of people’s life history, religious needs and preferences, which was used to develop positive relationships and provide person centred care. Information was made available in accessible formats to help people understand the care and support agreed.

People were encouraged to take positive risks and remain as independent as possible.

People made choices about their day to day lives and how they spent their time. People enjoyed a range of activities on offer and social events. People had visits from family and friends, and maintained links with the wider community. People’s religious and spiritual needs were met.

People had a range of methods to express their views about the service. People knew how to make a complaint and the provider responded to complaints and used the feedback to bring about changes to the service.

People and relatives all spoke positively about the provider, manager and staff team and the quality of care. Staff were committed to the provider’s vision of providing good quality care. The service had a good relationship with other agencies and worked in partnership where required to meet people’s needs.