Garfield House Care Home

Updated 24 January 2024

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.

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

The inspection was carried out by an inspector, a specialist advisor (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.

Service and service type

Garfield House 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. Garfield House Care Home is a care home without 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

The first day of the inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority. We used this information to plan our inspection. The provider was not asked to complete a provider information return (PIR) prior to this inspection. A PIR is information providers send to us to give us key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 3 people in depth and 3 people informally over lunch, who lived at the home, and 2 visiting relatives, to gain their feedback about the care provided. We spoke with the registered manager, the operations manager, a senior care worker, 2 care workers and an activities staff member. We also spoke with 3 visiting professionals. We reviewed a range of records, including 3 people's care records in detail, a selection of medicines records, 3 staff recruitment files, staff supervision and appraisal records and a variety of records related to the management of the service, including audits.

Updated 24 January 2024

About the service

Garfield House Care Home is a residential care home which provides personal care for up to 30 older people, people with a physical disability and people living with dementia. Accommodation is provided on the ground floor. At the time of the inspection 25 people were living at the home.

This service was previously part of Carders Court Care Home, a residential care home which provided personal and nursing care for up to 150 older people, people with a physical disability and people living with dementia. In September 2022, the provider split Carders Court Care Home into 5 separate care homes which were registered with the Care Quality Commission (CQC) individually. Garfield House Care Home is one of those services. The last inspection of Carders Court Care Home took place in February 2021.

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

Medicines and prescribed thickening powder were not always managed safely. Risks relating to the environment, people’s safety and health conditions had been assessed, though for 1 recent admission these had not been identified/acted on in a timely way. We made a recommendation around this. Staff were safely recruited, feedback about staffing levels were mixed. Lessons learned when things went wrong were taking place, though the home needed to improve how they share this information with staff. People were safeguarded from abuse and people told us they felt safe. The home was clean and tidy and people were supported to have visits from loved ones.

Staff supervisions were not always taking place in line with the providers policy. Staff competencies were checked and staff training completion rates were high. Peoples feedback about food was mixed and the meals provided did not always match the menu we were shown. We made a recommendation about this. The home was neutral in décor, though the environment could be improved for people living with dementia. People's needs had been assessed and people were supported by staff with their healthcare 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.

People told us they were treated with dignity and respect and people were supported to be as independent as possible. Records were securely stored, and people were able to express their views. People were supported to access advocacy when they needed to.

People were involved in planning their care; however, we received mixed feedback about people making choices. People told us they were able to choose things such as, when they went to bed, but people were not getting offered frequent showers. We made a recommendation about this. An activities coordinator supported people to take part in activities, however, feedback on activities was mixed. People’s communication needs were being met. Although there had been no complaints about the service, a complaints policy and procedure was in place should people want to raise any concerns. The service was not supporting anyone who was end of life at the time of the inspection, though staff had received training in this area.

Various governance issues were identified during our inspection, including issues around records and audits. Although the registered manager was aware of their responsibility under the duty of candour, they had not always reported incidents to CQC. Feedback about the registered manager was positive and staff knew how to report poor practice. Meetings for staff, relatives and people that use the service were taking place, though surveys had only been conducted with residents.

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

This service was registered with us on 29 September 2022, and this is the first inspection.

Why we inspected

We had planned to complete an inspection of Carders Court Care Home due to the rating at the last inspection and concerns we had received. When the provider changed the registration to split Carders Court Care Home into 5 separate care home services, a decision was made for us to inspect Garfield House Care Home, as some of the concerns we had received related to that home.

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.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, governance, staff supervisions and failing to notify CQC of necessary incidents at this inspection. We made recommendations around supporting people to shower, food choices and managing risks relating to bed rails.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.