Goodwins Hall Care Home

Goodwins Hall Care Home is a care home, providing nursing and personal care to up to 78 people. The service provides support to people with nursing care and support needs. At the time of our inspection there were 71 people using the service. The care home accommodates people across two floors and each floor is divided into units named Kingfisher, Skylark and Canary. The service provides care to people living with physical healthcare needs, and some people were living with dementia.

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

People were not always receiving their medicines on time in line with health care professional’s recommendations. Medicines were administered later than required, or they were not given at regular intervals across the day to achieve the best outcome.

People were not consistently protected from the risk of accessing items such as razors, denture cleaning tablets, and medicines without staff supervision, as there were no lockable storage units for such items to be kept in, which increased their risk of harm.

People’s care records needed to be reviewed to ensure they were an accurate reflection of individual support needs and preferences, for example how they liked to take their medicines.

Improvements were needed to the provider’s level of oversight of this service, to ensure people were kept safe, particularly in the absence of having a registered manager in post. Some of the provider’s own audits and checks had not identified shortfalls found during this inspection to ensure care people received as consistently of a high standard.

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.

There was an ongoing refurbishment plan in place to ensure improvements to the condition of the care environment, with plans to improve the condition of external paving to improve accessibility.

People were supported by suitably trained, competent staff, and staffing levels were found to be above the assessed levels of dependency to meet people’s individual care needs.

Overall, cleanliness within the service was a good standard, and people’s bedrooms were individually decorated to make them feel homely and personalised. Procedures in place, and observations during the inspection demonstrated staff were protecting people from the risks of the spread of infection and were following the provider’s policies in place.

The manager and provider team were responsive and open to inspection feedback, and were keen to drive improvement at the service to ensure people received consistent standards of care.

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 The last rating for this service was good (published 18 September 2019). We also completed an unrated inspection which was published on 16 March 2023 following a serious incident which happened at the service.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We had also received concerns in relation to the management of people’s safety prior to this inspection. We undertook a focused inspection to review the key questions of safe 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 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.

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

We have found evidence that the provider needs to make improvements in relation to the management of people’s risks, particularly in relation to medicines and the care environment. 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.

Follow up

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

About the service

Goodwins Hall Care Home is a care home, providing nursing and personal care to up to 78 people. The service provides support to people with nursing care and support needs. At the time of our inspection there were 67 people using the service. The care home accommodates people across two floors and each floor is divided into units named Kingfisher, Skylark and Canary.

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

People we spoke with told us they felt safe and well cared for living at the service. People were able to tell us of improvements that had been made to their care following a serious incident. This had supported people to feel safe.

In response to the serious incident, the provider was able to demonstrate actions taken to reduce the risk of reoccurrence, including updates to people's care plans and risk assessments. They were also able to show external advice and guidance sourced from specialist professionals.

Ongoing support was in place for staff and people who witnessed the serious incident, to maintain their wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible and in their best interests; the policies and systems in the service supported this practice. However, greater consideration was required where people were known to be at risk of neglecting their personal hygiene or declining to have their clothing regularly laundered.

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

The last rating for this service was good. (Published 18 September 2019).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about fire safety risks and the management of risk of harm to people's health and welfare. This inspection examined those risks. This was a targeted inspection that considered safe care and treatment.

Findings from this inspection do not change the previous rating for the service. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Goodwins Hall Care Home on our website at www.cqc.org.uk

Goodwins Hall Care Home is a residential care home providing personal and nursing care for up to 78 people aged 65, some of whom may be living with dementia. At the time of the inspection, 75 older people were using the service. The care home accommodates people two floors and each floor is divided into two units. One of the units specialises in nursing care.

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

People felt safe using the service and staff had a good understanding of how to identify and report any concerns.

Risks were fully assessed using recognised tools and management plans provided clear guidance to staff on how to minimise the risk.

People were supported by enough staff who were well trained, kind and caring and knew people well.

People received their medicines as prescribed by trained and competent staff.

People’s needs were holistically assessed, and people were cared for in a person-centred way.

The home was purpose built, adapted to people’s needs and kept clean and tidy.

Staff worked well as a team and also worked well with other professionals. Professionals were positive about their experience of working with 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.

People were involved in their care and supported to be as independent as possible. The layout of the home minimised restrictions on people’s movement to enhance independence.

There was a varied activities programme in place tailored to people’s needs. People were encouraged to be involved in the choice and delivery of activities as much as possible.

Staff knew people well and were able to respond quickly to people’s changing needs, although this was not always immediately updated in care plans.

There was a focus on end of life care. Staff recognised this as important and specific care plans ensured a holistic approach that reflected peoples wishes and preferences at the end of their life.

People and staff were positive about the management. There was an open culture focussed on continual learning and improvement.

There were robust systems in place for auditing and reviewing the quality of care and the manager had a plan of action to make further improvements to the service based on learning from quality assurance processes.

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 13 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home has had the current registered manager in post since January 2011. 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.

Staff were aware of safeguarding people from the risk of abuse and they knew how to report concerns to the relevant agencies. Individual risks to people were assessed by staff and reduced or removed. There was adequate servicing and maintenance checks to fire equipment and systems in the home to ensure people’s safety.

People felt safe living at the home and staff supported them in a way that they preferred. There were usually enough staff available to meet people’s needs and action was taken to obtain additional staff when there were sudden shortages. The deployment of staff at some times meant that people sometimes had to wait. Most recruitment checks for new staff members had been obtained before new staff members started work but more action was needed if information was not available.

Although medicines were securely stored, temperature checks of storage areas had not been taken, which put the effectiveness of medicines at risk. Medicines were safely administered, and staff members who administered medicines had been trained to do so. Staff members received other training, which provided them with the skills and knowledge to carry out their roles. Staff received adequate support from the registered manager and senior staff, which they found helpful.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service was meeting the requirements of DoLS. The registered manager had acted on the requirements of the safeguards to ensure that people were protected. Staff members understood the MCA and presumed people had the capacity to make decisions first. Where someone lacked capacity, best interest decisions had been made.

People enjoyed their meals and were able to choose what they ate and drank. Staff members worked together with health professionals in the community to ensure suitable health provision was in place for people.

Most staff were caring, kind, respectful and courteous. Staff members knew people well, what they liked and how they wanted to be treated. People’s needs were responded to well and support was always available. Most care plans contained information to support individual people with their needs. They did not always provide staff with enough guidance about behaviour that may challenge or upset others. People’s relatives said that people were happy at the home and that they were able to be as independent as possible.

A complaints procedure was available and people were happy that they did not need to make a complaint. The manager was supportive and approachable, and people or other staff members could speak with her at any time.

The provider monitored care and other records to assess the risks to people and ensure that these were reduced as much as possible and to improve the quality of the care provided.

There were policies and procedures in place to ensure staff knew how to recognise and report any safeguarding issues. People living in the home were also provided with information of how to report any suspected abuse. We saw that policies, procedures and appropriate practices were in place for the safe storage and administration of medications. This ensured the safety and wellbeing of people living in the home.

Staff received training and supervision on a regular basis and staff told us they felt fully supported by the manager at all times. This ensured that staff had the relevant training to meet the needs of people and that the manager was aware of any areas that needed strengthening. People living in the home told us they thought staff knew their job and how to provide any assistance in an appropriate way.

We saw records that showed us a quality audit was regularly undertaken by the organisation to monitor the quality of the service that was being provided. There were also monitoring systems in the home that informed the development of new processes.

Care and support was being regularly reviewed to ensure that peoples' needs were being met. There was evidence of people's involvement in the planning of their care and support.

There were safeguarding policies and processes in place. However, some improvements were needed to ensure the local authority safeguarding information was available.

There were regular ongoing training sessions in place to ensure that staff could safely deliver care and support to people. However, improvements were needed to ensure staff supervision arrangements were in place.

The home had an effective system to deal with complaints that people using the service. People and their relatives regularly had access to the manager and staff to resolve any concerns that they had.