Gifford House Care Home

Updated 11 November 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.

Inspection team

The inspection team consisted of 3 inspectors, 1 who was a registered nurse 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 Expert by Experience visited the service and made phone calls to relatives.

Service and service type

Gifford 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. Gifford House 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, including information from a monitoring phone call we carried out with the service in April 2023. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

The inspection

We spoke with 10 people who used the service and used observation to understand people’s experience of care. We met with 5 family members and 3 external professionals who were visiting the service. We reviewed 8 people's care records and multiple medication administration records.

We spoke with the registered manager, the deputy manager, the care manager, reception staff, 3 nurses, 8 care staff, domestic and maintenance staff. We met with the provider and the nominated individual. A nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at 3 staff files. We also looked at a variety of records relating to the management of the service and quality assurance arrangements.

After our visit we continued to seek clarification from the provider. We had email and phone contact with a further 3 professionals who worked with the service.

Updated 11 November 2023

About the service

Gifford House is a residential care home providing personal and nursing care for up to 102 older people. At the time of our inspection 82 people were receiving a care service at Gifford House.

Care is provided across 4 units over 2 floors. When we inspected all 82 people were receiving nursing care; some were also living with dementia. Each unit has separate communal rooms such as dining rooms and lounges.

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

There had been improvements since our last inspection and people were being supported safely. However, improvements in quality checks and management oversight were required so people could be confident they would receive safe, good quality care.

Relationships with external stakeholders were not always open and positive when concerns were raised about care. The provider and registered manager had not fully engaged with local networks and external resources and were not always aware of best practice.

Care records were not always completed effectively. A new electronic programme had been purchased which would support improvements in oversight and recording.

Additional staff had been recruited to improve the maintenance of the service. The provider was continuing to enhance the design and décor, in particular, to ensure it supported people living with dementia.

Feedback from people and relatives was largely positive.

There were systems in place to safeguard people from abuse. We made a recommendation about increasing the focus on safeguarding throughout the service. There were enough staff to provide safe care. Planned recruitment of activity staff was in place to support people’s wellbeing. Medicines were administered safely. Staff supported people to minimise the risk of infection.

There was a consistent management and staff team. There had been a marked improvement in staff training and morale. Staff retention was good and the use of agency staff was reducing.

People had personalised risk assessments and care plans. Staff monitored people’s health and referred them to external agencies as required. People ate and drank in line with the preferences and needs.

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.

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 January 2020).

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.

Follow up

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