The Old Garden Care Home

Updated 6 October 2021

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.

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

This inspection was undertaken by an inspector 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.

Service and service type

The Old Garden 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.

The service had a manager registered with the Care Quality Commission. 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 inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used this information to plan our inspection.

During the inspection

We spoke with the registered manager, deputy manager and four other members of the staff team. We also spoke with three people who used the service about their experience of the care provided and six relatives.

We reviewed a range of records. This included four people's care records, a number of medication records, four staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.

We also received the providers information return during the inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 6 October 2021

About the service

The Old Garden is a care home, providing nursing and residential care for up to 40 people, some of whom are living with dementia. At the time of the inspection, there were 38 people living in the home.

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

Staff were aware of government guidance for COVID-19 testing and told us they completed tests as required. However, records of tests were not always robustly maintained. We made a recommendation about this in the main body of the report. The registered manager acted on this straight away and implemented new procedures to ensure all tests were completed and recorded. The home appeared to be clean. An infection prevention and control policy was in place and staff utilised PPE effectively. Regular checks were made on the building and the equipment to ensure it remained safe.

People told us they felt safe at The Old Garden. Staff were aware of safeguarding procedures and referrals had been made when needed. Risks to people had been assessed and measures were in place to mitigate identified risks. People were supported by staff who had been recruited safely and there were enough staff on duty to meet people’s needs in a timely way. Medicines were managed safely by staff who had undertaken training and had their competency assessed.

People’s nutritional needs had been assessed and care plans informed staff of people’s needs and preferences and people told us these were met. Feedback regarding the quality and choice of food available was positive. People’s needs were assessed prior to them moving into the home and referrals were made to other professionals for advice when needed. People described instances when staff have provided support that has significantly improved their health and wellbeing.

Records showed that people’s consent to care was sought and recorded. 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 and their relatives were very complimentary about the care and support provided to people. People told us they were treated well, respected and had their dignity and privacy maintained. Relatives said they were able to relax knowing their family members were being well cared for.

People felt involved and chose how they spent their day. There were regular meetings so they could share their views of the service and make suggestions. Person centred plans were in place that were reviewed regularly. Staff told us they knew people well and how they wanted to be supported. A relative told us, “The care seems to be really very much centred around the person.”

People had been supported to maintain contact with their relatives throughout the COVID-19 pandemic. New equipment was purchased to facilitate video calls and regular newsletters shared to keep people informed. Staff were also supporting safe visiting within the home, as well as a range of activities and trips out in the minibus.

Feedback from people and their relatives regarding the management of the service was positive and everybody told us they would recommend the home to others. Staff told us they enjoyed their jobs and were well supported by the management team. The registered manager was aware of their responsibilities, worked with others to ensure people’s needs were met and had notified CQC of all reportable incidents. Systems were in place to monitor the quality and safety of the service and these enabled the provider to maintain effective oversight of the service.

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 24 September 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.