Guys Cross Nursing Home

Guys Cross Nursing Home is a residential care home providing personal and nursing care to up to 34 people. The service provides support to people with a mental health condition. At the time of our inspection there were 30 people using the service. Care and support is provided on 4 units which are split across 3 floors. People had their own bedroom with its own en-suite. Each unit has its own dining area, lounge and kitchen.

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

People received safe, effective care which achieved good outcomes. There were enough suitably trained and skilled staff to meet people's needs safely and effectively. People told us they felt safe and were comfortable in the presence of staff who interacted with people in a relaxed and friendly manner.

People were protected from the risk of abuse. Where safeguarding concerns had been raised, these had been dealt with appropriately.

Risks to people’s health and well-being had been identified, assessed and managed well. Where people experienced episodes of distress, care records contained detailed guidance for staff to follow to enable them to support people safely and mitigate risks of further distress. This included strategies to distract or re-direct the person to improve their emotional well-being.

Some people had physical healthcare conditions, for example, diabetes or conditions that impacted on their mobility. Detailed risk management plans informed staff how to support the person and identify any changes which could indicate a deterioration in their health.

People were involved in decisions about their care. People were asked every day for feedback about the way in which their care had been delivered and people felt able to make their own 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.

Systems and processes ensured medicines were managed safely. This included how they were ordered, stored, administered, recorded and disposed of.

People told us they enjoyed the food and had a choice of when and what they ate. Where people had risks around their eating and drinking, staff were provided with clear guidance about what support the person required to minimise those risks. Input from other healthcare professionals such as the speech and language team had been sought.

Staff worked collaboratively with other healthcare professionals to ensure a successful transition between services. People were encouraged and supported to engage with other healthcare professionals to ensure their mental and physical health was maintained. This included the GP, physiotherapists and psychiatric services.

People and relatives consistently told us the home was well-led. There was a positive culture within the home and staff understood the ethos and values the provider promoted. Staff worked in partnership with people to ensure they could have the best possible outcomes in line with their personal wishes and preferences. Systems and processes were in place to ensure people received high quality care. A range of quality checks were in place to ensure any issues could be identified and acted upon quickly.

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 25 November 2017).

Why we inspected

The inspection was prompted in part due to the length of time since the last inspection. We also received concerns about the management of people’s finances. A decision was made for us to inspect and examine this risk.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk from this concern. Please see safe and well-led sections of this full report.

The overall rating for the service has remained the same based on the findings of this inspection.

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 COVID-19 and other infection outbreaks effectively.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Guys Cross Nursing Home is a nursing home providing accommodation and rehabilitation for up to 34 people with severe mental health disorders. The home consisted of four units over three floors. There were 32 people living in the home at the time of our inspection.

A requirement of the service’s registration is that they have a registered manager. 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 time of our inspection there was a registered manager working at the service.

At the last inspection on 2 November 2015 the service was rated Good. At this inspection we found there was a real sense of integration and companionship between the staff and the people who lived at the home which was outstanding. Overall the service remained Good.

Staff were very motivated and enthusiastic to provide people with a homely environment where they felt valued. They had built good, supportive relationships with people and had a clear understanding of people's needs, wishes and expectations. Staff promoted people’s privacy and dignity by being aware of their moods and emotional wellbeing and supported people's diverse needs.

People had ownership of their care plans which were developed with them and built around what they wanted to achieve in their lives. Staff worked within the principles of the Mental Capacity Act 2005 because people were encouraged to be as independent as possible and empowered to take responsibility for their own lives and make their own decisions.

There were enough staff on duty to provide safe and effective care and respond to people’s requests for assistance. Staff understood their responsibilities to protect people from the risk of abuse and the provider checked staff’s suitability before they started working at the home. Staff received training, support and supervision to enable them to effectively carry out their role and responsibilities. Staff were positive about their role in supporting people and had a clear understanding of the provider's values in care.

Staff supported people to maintain their health. Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks to people, whilst continuing to promote people’s independence. People received their medicines in line with nationally recognised standards for safe medicines management.

People were encouraged to participate in activities in the home and in the wider community. This ensured people were given support to maintain interests and friendships that were important to them and which promoted their emotional wellbeing.

Quality monitoring and auditing systems were in place, where each month regular checks were made to ensure a safe, effective, responsive and well-led service was provided.

People we spoke with told us that the care that was discussed with them matched the care that was provided to them. We saw that regular reviews of people's support plans described their progress towards their goals. We saw staff listened to people's input about their care needs and their wishes.

We observed people's independence was promoted throughout our inspection and people were involved with the running of the home.

We found that the support plans were person centred and reflected people's individual needs. We noted that members of staff supported people as detailed within their care plans. We saw staff were compassionate and caring when supporting people.

We saw the home was clean and tidy. We found the home had a cleaning schedule in place and was checked on a regular basis.

People we spoke with told us that staff were friendly and supported their needs well. We saw staff understood people's care needs and how they needed to be supported.

We found the service was well led and had systems in place to monitor the quality of service being provided.