Old Gates Care Home

Updated 23 March 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

The inspection was carried out by an inspector, a medicines inspector and an Expert by Experience on day 1 of the inspection, and 2 inspectors on day 2 of the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Old Gates Care Home 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. Old Gates 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not 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

During the inspection we spoke with 7 people who used the service and 5 relatives about their experience of the care provided. We spoke with 13 members of staff including the regional manager, registered manager, clinical service manager, unit manager, nursing assistants, senior carer, care workers, chef, domestic and activities coordinator.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at records relating to people's care and support including care plans, risk assessments and medicine administration records. We looked at 4 staff recruitment files. A variety of records relating to the management of the service were reviewed including health and safety checks, meeting notes, training records, policies and procedures and audits.

Updated 23 March 2023

About the service

Old Gates Care Home is a residential care home providing accommodation for persons who require nursing or personal care to up to 90 people. The service provides support to older people and those living with a physical disability or dementia. At the time of our inspection there were 52 people using the service who resided in two separate units, each with separate facilities. There was a third unit which had recently been closed and was not in use.

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

We have made recommendations about the management of some medicines and staffing levels and deployment. Staff were employed following a safe and robust recruitment process.

Safeguarding training was mandatory, and staff were aware of the processes to follow to ensure they could keep people safe. Risks relating to people that used the service and the premises were assessed and effective infection prevention and control was embedded in the home.

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. Staff received training that was relevant to their role as well as regular supervision and appraisal. People were supported to maintain a healthy and balanced diet and their needs had been assessed in detail. There was involvement from external agencies in the delivery of care at the home.

Staff supported people in a caring and considerate way which respected their privacy, dignity and independence. People were able to express their wishes and relatives praised the staff approach. Staff had a good knowledge and understanding of people's specific care and support needs and how they wished to be cared for.

People’s support plans were detailed and reviewed regularly. Their communication needs were met, and the staff understood their needs well. People were involved in activities in the home and the local community and they were supported to maintain relationships that are important to them. Complaints and concerns were investigated fully, and lessons learned where appropriate.

A range of audits and quality assurance checks were being completed and improvements had been made. The medicines audit did not always identify the monitoring of equipment for those with long term health conditions. We made a recommendation about this. Staff and relatives spoke positively of the registered manager who was described as, “Approachable", “Helpful” and “Flexible." Staff told us that they were supported by the management who had implemented a culture of continuous learning and development.

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

Rating at last inspection and update

This service was registered with us on 8 April 2022 and this is the first inspection. The last rating for the service under the previous provider was requires improvement, (published 7 December 2019.) 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 and the provider was no longer in breach of regulations.

At our last inspection we made a recommendation about training. At this inspection we found that improvements had been made and staff training records were up to date.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Recommendations

We have made recommendations in relation to medicines records, medicines audits and staffing levels.

Follow up

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