Gregory Court

Updated 29 October 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was undertaken by one inspector.

Service and service type:

Gregory Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Since the last inspection, the registered manager had left the service. The service had had an interim manager and a new manager had been appointed. They were in the process of submitting their registered manager application. 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.

Notice of inspection:

This comprehensive inspection was unannounced.

What we did:

Before our inspection, we reviewed information we held about the service. This included the last inspection report, information received from local health and social care organisations, and statutory notifications. A notification is information about important events, which the provider is required to send us by law, such as, allegations of abuse and serious injuries. We used the information the provider had shared in the Provider Information Return (PIR). This is information we require providers to send us to give key information about the service. We used all this information to help us to plan the inspection.

During our inspection, we spoke with six people who lived at the service, a visiting relative and a visiting health care professional. We spoke with the manager, personalisation manager, deputy manager, a team leader, two support workers, the cook and domestic. To help us assess how people's care needs were being met we reviewed all, or part of, three people's care records and other information, for example their risk assessments. We also looked at the medicines records of seven people, three staff recruitment files and a range of records relating to the running of the service. We carried out general observations of care and support and looked at the interactions between staff and people who used the service.

After our inspection visit, we continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with another relative.

Updated 29 October 2019

About the service:

We conducted an unannounced inspection at Gregory Court on 14 and 15 October 2019. Gregory Court provides personal care and accommodation for up to 10 people living with physical disabilities. It is one of a number of homes run by the charity The Disabilities' Trust. The service is a predominantly a single storey building, and has 10 flats within it, each of which has an ensuite bathroom and a kitchen area. All of the flats, with the exception of one, are on the ground floor. On the day of our visit, seven people were living at the service.

People’s experience of using this service:

Improvements had been made to how risks were assessed, managed and monitored. There was a positive approach to risk management and people were involved in discussions and decisions in how risks were planned for. Incidents and accidents were monitored and there was a system to investigate, learn and improve when incidents occurred. Further improvements were being made to the analysis of incidents for themes and patterns.

People told us they felt safe living at the service and they had access to information and opportunities to discuss any safeguarding concerns. Staff had received safeguarding training and were clear about their role and responsibilities in protecting people from harm.

People were supported by sufficient numbers of staff who were competent, skilled and knew people well. Staff levels were monitored and increased to support people with appointments and activities when required. Safe staff recruitment checks were completed when staff commenced their employment.

The management, administration and storage of medicines had improved, and people were receiving their prescribed medicines. Shortfalls were identified in the recording of hand-written entries on people’s medicines administration records. However, the manager took immediate action to address this with staff to make improvements.

Best practice guidance in relation to infection prevention and control was followed and health and safety checks were completed on the environment and equipment.

Improvements had been made with staff training and support, this included additional training, and staff received regular opportunities to discuss their work training and development needs.

People received opportunities in developing the menu and their nutritional and hydration needs were met and independence was promoted. People were supported with their health care needs and accessed external healthcare professionals and services. Information was shared with external healthcare agencies to support people to receive consistent care.

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's care and support had been planned in partnership with them. People and their relatives felt consulted and listened to about how their care would be delivered.

People and their relatives felt that staff were kind and caring. People’s privacy and dignity was respected, and their independence actively promoted.

People were supported with opportunities to pursue social activities, interests and hobbies and were active citizens of their local community. People were supported to identify and achieve personal goals. End of life wishes had been discussed with people. People had no complaints but knew how to raise any concerns and were encouraged to do so.

Staff had access to policies and procedures that reflected legislation and current best practice. Changes had been made to the management team who had worked hard to make improvements. The management team were enthusiastic and had a positive approach and drive to further develop the service. A new role within the organisation had been developed to lead on personalisation and this was starting to have a positive impact.

New and improved systems and processes were in place to continually monitor and improve the quality of the service. These was having a positive impact, but it was recognised these needed further time to fully embed and be sustained. People and staff were encouraged to be involved in developing the service.

Rating at last:

At the last inspection the service was rated Requires Improvement (published 11 October 2018) and there was one breach in 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 and the provider was no longer in breach of regulations.

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

Why we inspected:

This was a planned inspection based on the rating of the last inspection.

Follow up:

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