Gilling Reane Care Home

Updated 15 December 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 Care Act 2014.

Inspection team

The inspection was completed by 1 inspector and 1 regulatory coordinator.

Service and service type

Gilling Reane 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. 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, commissioners and professionals who work with the service. We also looked at information we had received and held on our system about the service, this included notifications sent to us by the provider and information passed to us by members of the public.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service. We spoke with 5 relatives about their experience. We spoke with members of staff including the registered manager, a regional manager, care workers and a member of the domestic staff. We also spoke with 4 external health and social care professionals and received their feedback of the quality of the service.

We looked at a variety of records to gather information and assess the level of care and support provided to people. We reviewed in detail 4 care records. We looked at staff rotas, risk assessments, multiple medicine records and 4 recruitment files. We also considered a variety of records relating to the management and governance of the service, including policies and procedures.

We looked around the home in both communal and private areas to establish if it met the needs of people who lived there and if it was safe.

Updated 15 December 2023

About the service

Gilling Reane Care Home is a care home providing personal and nursing care and accommodation to older people. At the time of the inspection, 30 people were receiving regulated activities at the home. The service can support up to 33 people. The home is an adapted building with bedrooms based over 2 floors.

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

Some aspects of staff recruitment and employment discipline were not effective at ensuring staff members were always suitable to work with vulnerable people. Some essential safety checks and statutory process had not been made. There was inappropriate oversight of these processes by the provider. Further detail is in the 'safe' and 'well-led' sections of this report.

The registered provider was responsive to concerns noted during the inspection and took action to make improvements and promote safety of all staff who had been employed at the home. The service made appropriate notifications to CQC and other authorities of safety incidents to ensure these incidents received appropriate oversight.

People, their relatives and staff were confident in the management team at the home and praised how approachable they were. Staff said they were appropriately trained and supported. Records we observed supported this position.

Care and support risks to people were appropriately identified, assessed and managed in a timely way. Staff said the use of the service's digital care recording system assisted with this and helped communication around people's needs and any changes to their support requirements.

People received their medicines as prescribed by health care professionals. Staff were competent in this area and consulted external professionals when they came across issues.

Infection, prevention and control processes were appropriate and we were assured about the service's ability to mitigate the transmission of infections.

Staff were competent with safeguarding processes and knew how to protect people from abuse. Relatives said their loved ones felt safe in the home and were trusting of staff and management. The service's safeguarding processes were robust. We observed good practices and interactions between staff, management and people during the inspection.

Staff supported people to have access to healthcare professionals and specialist support and the service worked with external specialists. Professional's views on the service were positive.

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 good (published 20 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we carried out 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. The overall rating for the service has changed to requires improvement. This is based on the findings at this inspection.

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

We have found evidence that the provider needs to make 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.

Following our inspection the provider completed an investigation into the employment and oversight issues. This identified the concerns in detail, the steps that were to be taken to resolve matters and how lessons had been learned.

Enforcement

We have identified breaches of regulations in relation to unsafe employment processes and the governance/oversight of the service at this inspection.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority and other partner agencies to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect and will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.