Gladstone House

Updated 23 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by two inspectors on the first day of inspection 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. The second day of inspection was undertaken by a medicines inspector.

Service and service type

Gladstone House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Beechwood Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and other professionals who work with the service. The provider was asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 2 relatives about their experience of the care provided. We spoke with 2 members of staff, the registered manager and deputy manager.

We conducted a tour of the service and looked at a wide variety of records. These included multiple care and medicine records, monitoring documentation, staff files and audits used to monitor the service.

Updated 23 September 2023

About the service

Gladstone House is a care home providing accommodation for people who require personal care and nursing care to up to 12 people, some of whom may be living with mental health issues and or a learning disability. At the time of our inspection there were 8 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

The provider didn’t always give people care and support in a clean and well-maintained environment. We made a recommendation regarding infection prevention control measures in place and to review the service refurbishment plan.

Medicines were not always managed safely. The guidance for medicines taken ‘when required’ and documentation for these medicines were not always clear. The medicines policy in place stated homely remedies could be offered, and people told us these types of medicines were not available.

Staffs competencies to administer medicines was checked. Staff told us people were supported with administering their medicines in a way that promoted their independence. However, more development was needed in this area to build up people’s skills.

Care plans were improved for people to support their mental health, emotional well- being, personal care and dietary needs. Care plan monitoring records were improved to include tracking people’s progress.

The provider supported people to have the maximum possible choice, control and independence and they had control over their own lives. People were encouraged to plan ahead, set aspirations and work toward personal goals.

Fire drills were taking place regularly, issues with the fire doors being unsafe at our last inspection had been fully addressed.

Right care

The provider acted to protect people from poor care. The provider reported any concerns to the appropriate places. Staff had training on how to recognise and report abuse.

The provider had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff were recruited appropriately with the correct safety and suitability checks.

People were supported by person-centred practices; care plans were improved and included personalised plans with achievable goals and outcomes. People were encouraged to take positive risks. Risk assessments were in place.

Right culture

People were supported to lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. The quality assurance processes in place were improved and were more effective. People and those important to them, including advocates, were involved in planning their care.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 12 December 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made. However, the provider was still in breach of regulation.

This service has been in Special Measures since 12 December 2022. During this inspection the provider demonstrated improvements have been made. The provider is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected.

We carried out an unannounced comprehensive inspection of this service on 26 July and 1 August 2023. A breach of legal requirements were found. This inspection was carried out to follow up on action we told the provider to take at the last 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.

We have found evidence the provider needs to make further improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from inadequate to requires Improvement based on the findings of this inspection.

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

Enforcement

We have identified a continued breach in relation to medicine management at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.