We carried out a review of the data available to us about Gorselands Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gorselands Care Home, you can give feedback on this service.
We found the following examples of good practice:
All visits to Gorselands had to be pre-booked. Visitors to the home were met at the front gates by a member of staff and provided with a supply of personal protective equipment (PPE). They were asked to wash their hands and put on the PPE. Healthcare and social care visitors had to have evidence of a recent negative COVID-19 test. Family and friends had to have a negative lateral flow test (LFT) before being permitted to visit.
On the day of this inspection, the first in-person visit was being made by a family member. These visits take place in one designated area of the home only and the room was cleaned thoroughly after use. The provider was being cautious in ‘opening up the home’ and these visits were being made available twice a day, six days a week. The room can be well ventilated. Alternative arrangements were in place to keep other people and their relatives/friends in contact. For example, telephone, email and video calls.
Staff entered the home via the back door. They were required to use hand sanitising gel on entering the home, then go straight into the donning and doffing room and apply their face mask and gloves. PPE stations had been set up in various places around the home.
A COVID-19 testing programme was in place for all staff and the people who lived at Gorselands. Staff were tested twice a week using the LFT test and once a week a full PCR test. People were tested every 28 days but more often if presented with any COVID-19 symptoms. The service had plentiful supplies of PPE and we saw this being used correctly.
Visits from healthcare professionals such as GPs and community-based nurses and allied healthcare professionals had been kept to a minimum. The provider and registered manager had good links with the surgery and spoke to a named professional at least weekly. All 28 people and 95% of the staff team had received their first dose COVID-19 vaccination, with the second dose planned at end of March/beginning of April.
People were supported by the staff to maintain the two-metre social distancing rule, however due to people’s dementia this was not always possible. Staff socially distanced from their colleagues, including when they were taking drink and meal breaks. When they were delivering personal care they wore face masks, gloves and a plastic apron. The provider had already obtained a supply of additional PPE should there be an outbreak of infection in the home.
The activities coordinator and staff team continued to support people with activities of their choosing. Small and larger group activities were arranged. During this inspection we saw people singing, dancing, or having one-to-one time with a member of staff. The home was spacious with many communal areas so people and the care staff were able to space out.
At the time of this inspection the home had two vacant rooms, but these were deliberately being kept available. During the pandemic, several people had been admitted. Because of the difficulties in isolating any new person in their bedroom for the first 14 days, the provider had arranged for one person to be admitted after they had already isolated in their own home for 14 days and had a negative COVID-19 test result.
The provider said if there was an outbreak of COVID-19 within Gorselands, it would be possible to cordon off an area of the home in order to prevent further spread of infection.
Infection prevention and control training was part of the mandatory training programme each staff member had to complete, but extra training had been delivered during the pandemic. All staff had received COVID-19 specific training which included hand hygiene and donning and doffing of PPE. The provider had updated their infection prevention and control policies always taking into account guidance instructions from Public Health England, CQC, the Local Authority and the Department of Health and Social Care.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated good:
Staffing levels were safe to meet people’s needs and robust recruitment procedures were conducted. Medicines were administered safely. Risk assessments were in place to support people safely whilst promoting people’s independence. Staff were knowledgeable about how to safeguard people from abuse.
Staff had an effective induction when they started work at the service. A programme of regular training for staff was completed to ensure knowledge and practice was at the expected standard. People were supported to access healthcare. People are supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible.
Staff were kind and caring. People had good relationships with staff. Care plans were person centred. People were involved with the local community and networks were established. There was a range of activities available for people to participate in. People were involved in choosing developing activities. Feedback from people was sought through meetings and surveys and suggestions implemented.
Policies and procedures were not always up to date or clear when they had been reviewed. Systems were in place to monitor and improve the quality of the service but required further development. People, relatives and staff spoke positively about how the service was run and managed.
We carried out this unannounced 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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service
Gorselands Care Home provides care and accommodation for up to 30 people. The home specialises in the care of older people living with dementia.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. Both the registered manager and the provider were available for the whole of the inspection.
On the day of the inspection there was a relaxed and caring atmosphere in the home. People were observed to be following their own choices and were able to go into the secure gardens when they wished. One person told us, “I am really happy here I feel safe and it is comfortable”. A relative told us, “The care here is really good I am glad I found this home”.
People’s health care needs were fully assessed and care and support was provided on an individual level. This meant people’s individual needs were considered and catered for. Care plans and care practices were monitored to ensure best practices were being followed and improvements were made when needed.
People, staff and relatives told us there was an open and approachable ethos in the home. We observed people chatting freely with the provider, registered manager and staff throughout the day. They appeared relaxed and at ease during the conversations.
People told us staff were caring and knowledgeable about their needs. One person told us, “Sometimes they know what I need before I do”. Records showed staff had all received appropriate training to provide the care and support people needed. The provider had plans in place to ensure staff continued to attend training to keep up to date with good care practices.
Everybody spoken with told us they enjoyed the food, one person told us the food was “excellent”. We saw people were offered choices and the food was nutritious and well presented.
There was an activities programme in place. Due to unplanned sick leave the morning activities organiser was not in the home. This meant during the morning we saw little in the way of organised activities; however we observed staff carried out one to one activities with some people. During the afternoon people were fully engaged in preparing their entries for a local flower show.
The majority of care staff had received training in identifying and reporting abuse. All staff spoken with were able to explain to us the signs of abuse and how they would report any concerns they had. They all stated they were confident any concerns bought to the provider and registered manager would be dealt with appropriately.
The provider had systems in place to monitor the care provided and people’s experiences. A regular survey was carried out asking people and their relatives about the service they received. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.
Gorselands support people with dementia therefore some of the individuals we spoke with were unable to tell us about their experience of their care. However, some people commented positively about the care and support they were receiving. Comments included 'the staff are lovely, cannot fault it here', 'the food, the staff and my room is lovely'.
We observed how people were supported during the early morning and during meal times. People were supported in a sensitive and respectful manner. Staff were knowledgeable about the people they were supporting.
Care and support was assessed and planned. Each person had a care plan detailing their support needs. These had been kept under review. When needed people had access to other health professionals.
People were provided with meaningful activities both in the home and the community.
People's nutritional needs were being met and kept under review.
Sufficient staff supported the individuals throughout the day. Many of the individuals were choosing to get up early in the morning. Assurances were given by the provider that a review of staffing would be completed to ensure suitable numbers of staff were present in the home from 0700 to 0800.
Systems were in place to monitor the quality of the care provided, including seeking the views of people who use the service and their representatives.
Gorselands Care Home support people with dementia, therefore some of the individuals we spoke with were unable to tell us about their experience of their care. However, some people did tell us they were happy with the care they were receiving. Comments included; 'I have no complaints', 'the staff are lovely', and 'it is very lovely here I would not choose to go anywhere else'.
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were provided with meaningful activities both in the home and the community.
Systems were in place to monitor the quality of the care provided, including seeking the views of people who use the service and their representatives.
People we met and spoke with during our visit were able to tell us 'I like living here and I am very well looked after', 'we are asked what we would like to eat and whether we want to join in with things' and 'the staff are all very kind to me'.
Two visitors who were in the home to see their relatives told us 'my mother gets brilliant care' and 'my mother is treated with respect and is very well looked after'.
People told us that they received the care and support that they needed. 'They couldn't do much better. I am so well looked after', 'I am very well looked after and I want for nothing' and 'everything is very friendly here and I get the help I need'. Relatives told us 'the care and attention my mother receives is first class. As a family we have every confidence that she is being well looked after' and 'we are kept informed of any changes, communication with the home is good'.