Godolphin House Care Home

Godolphin House Care Home provides care and support for up to 32 older people. At the time of the inspection the service was supporting 26 people. The service is part of a group of three care homes in Cornwall.

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

People told us they felt safe living in the service and staff provided care with compassion. The atmosphere in the service’s communal spaces was relaxed and people were supported to participate in a range of activities. The service had a dog that people enjoyed interacting with.

The service was appropriately staffed on the day of the inspection and rotas showed although staffing was challenging safe staffing levels had been consistently achieved. The providers recruitment practices were safe and 4 additional staff had been recently recruited.

Risks were managed appropriately, and staff had the skills and support necessary to meet people’s needs. People received their medicines as prescribed.

There were appropriate infection control measure in place and an ongoing programme of improvement to the service environment. The toilet adjacent to the lounge did not have a lock and we have recommended the service seeks advice on how to ensure people dignity is protected while using this facility.

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.

The service worked effectively with health professionals to ensure people needs were met and additional systems had been introduced by the provider to ensure information and advice provided was accurately documented.

There was a registered manager in post who was responsible for this and one other of the provider’s services. The registered manager spent two days each week in the service and was supported by a deputy manager and senior team leader. Staff told us they were well supported by the leadership team.

Quality assurance systems were effective, and the service regularly received compliments and positive feedback.

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 the service was Good published on (19 May 2018). At this inspection the service has remained good.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

As a result, we undertook a focused inspection of Godolphin House to review the key questions of Safe, effective and Well-led only.

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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

Recommendations

We have recommended the provider seeks guidance on how to ensure people’s dignity is protected while using toilet facilities independently.

Follow up

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

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

During our inspection visit there was a friendly and relaxed atmosphere at the service. People were able to make choices about their daily lives and most people spent time in the shared lounge enjoying the activities on offer. In the morning this included a knitting club and bingo in the afternoon. We observed people had good relationships with staff and each other. Staff interacted with people in a respectful, caring and compassionate manner.

People received care and support that met their needs because there was a stable staff team who had the skills and knowledge to provide responsive and personalised care. People told us they were happy with the care they received and believed it was a safe environment. Comments included, "It’s the staff being around so much that makes me feel safe", "There's always somebody around if you’re in trouble", "I know I can use my call bell if I need help", "I feel safe because they are so nice to me", "I'm in very good hands here" and "Mum feels safe because there are no raised voices in here."

People’s care plans contained personalised information about their individual needs and wishes and people were involved in the planning and reviewing of their care. These care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted.

Incidents and accidents were logged, investigated and action taken to keep people safe. Risks were clearly identified and included guidance for staff on the actions they should take to minimise any risk of harm. Risk assessments had been kept under review and were relevant to the care provided.

Safe arrangements were in place for the storing and administration of medicines. Staff supported people to access healthcare services such as occupational therapists, GPs, chiropodists, district nurses and opticians.

People were supported to eat a healthy and varied diet. Comments from people about their meals included, "There's always a good choice of meals”, "The food is very nice and a good choice of food", "The food is always hot when it comes to my room", "The food is fantastic" and "We have beautiful food."

Staff understood and, applied in practice, the principles of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Where people did not have the capacity to make certain decisions the service acted in accordance with legal requirements. Applications for DoLS authorisations had been made to the local authority appropriately.

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs in a timely manner. Staff knew how to recognise and report the signs of abuse. Staff were supported to develop the necessary skills to carry out their roles through a system of induction, training, supervision and staff meetings.

The environment was clean, odour free and well maintained. However, on the day of the inspection some sinks had no hot water and others had water that was too hot. We were advised that some work had been carried out to the boiler the day before our visit and this had caused the problems with the hot water. Action had been taken to alert people about these risks. After the inspection the registered manager informed us that the boiler had been repaired.

There was a positive culture within the staff team and the management provided strong leadership. There were opportunities for staff to raise any concerns or ideas about how the service could be developed. Staff told us they felt supported and listened to by the management. Their comments included, “Management help us if we are busy”, “The management are all about people having quality care” and “Best place I have ever worked.”

People, relatives and healthcare professionals all described the management of the service as open and approachable. Comments included, "This place is a miracle", “This is one of the better homes” and "I can go on holiday with peace of mind, knowing (person) is well cared for." There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The service had a suitable complaints procedure.

Further information is in the detailed findings below.

The service is registered to provide care and accommodation for up to 31 people. On the day of our inspection 27 people some of whom had a diagnosis of dementia were living at the service.

There was a registered manager in post at the time of this inspection. 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.

People were relaxed and comfortable in the service and told us they were safe and well cared for. People said “They look after me very well”, “The staff are all lovely, very nice” and, “They are just nice people.” People’s relative also told us; “The staff are lovely. [My relative] is well looked after”, “The staff are extremely helpful and cheerful. There is a nice atmosphere here” and, “The staff are gentle, kind and affectionate.”

Staff knew people well and provided calm and compassionate support throughout our inspection. People requested support from staff without hesitation and staff told us; I like it here, there are some real characters” and, “The staff are all lovely with the residents.”

The service was fully staffed and there were no vacancies in the staff team. During our inspection we found sufficient numbers of staff were available to meet people’s care and support needs. Staff recruitment processes were robust and designed to ensure all new staff were suitable for work in the care sector.

Assessments of risks had been completed and people’s care plans included guidance for staff on the action they must take to protect people from identified risks. Where accidents or incidents had occurred these had been documented and fully investigate.

Records demonstrated all staff had received regular training updates and appropriate supervision to ensure they were sufficiently skilled to meet people care needs. Staff told us, ““The training has been very good” and, “The managers are very supportive when it comes to training.”

People’s care plans had been developed from information gathered during the assessment process and regularly updated to ensure they reflected people’s current care and support needs. These documents provided staff with clear direction and guidance and included information about the person’s background, life history and interests.

People received regular support from external health care professionals and any guidance provided, had been incorporated into people’s individual care plans.

Staff and managers consistently acted in accordance with the requirements of the Mental Capacity Act 2005 (MCA). The registered manager had recognised that some people’s care plans were potentially restrictive and appropriate applications for the authorisation of these care plans had been made to the local authority. The registered manager told us, “Often I will ring the DoLS team for information if I am not sure.”

Staff respected people’s decisions and choice and one person told us, “I can do what I like.” People care plans included information for staff on how to respond where care was declined and staff told us, “You can’t push yourself on people” and, “I went in to see [person’s name] today but she asked me to leave so I did.”

People told us; “The food is very very good” and, “The food is lovely, excellent meals with nice vegetables and gravy. I like that.” While the cook said, “Everything is fresh and home cooked here. We make fresh cakes every day.” Where people required support at meal times this was provided discreetly. People were offered drinks regularly throughout the day and each morning staff visited people to discuss the day’s menu. At lunch time a choice of two hot meals was available and other dishes could be prepared if requested.

The service employed two part time activities coordinators who were supported by two volunteers. Staff told us, “We have an activities coordinator on duty every day except Sunday” and, “There is always something going on activities wise.” Each month there was an activities theme which culminated in an event with in the service. The theme of the month of our inspection was “Crufts” and a dog show had been held at the service on the day before our inspection. Staff had created numerous games based on the theme, nine dogs owned by staff and relatives had visited during the day and the cook had prepared paw shaped cakes and bone shaped biscuits in support of the event. People told us this event was; “Brilliant” and, “Thoroughly enjoyable.” While staff commented, “Yesterday was good, it was really well received.”

The service was well led by the registered manager. Staff told us, “The registered manager is great really approachable. She takes an interest and cares. I would be happy to go to her with anything.” While one person told us, “I am very very happy with the registered manager. We get on like a house on fire.” There were appropriate procedures in place to monitor the service’s performance. Residents meeting were held regularly and were feedback was provided it was acted upon by the service’s management team.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence support our summary please read the full report.

Is the service safe?

On the day of the inspection we judged that the service was safe.

The provider had taken adequate steps to ensure the people employed at Godolphin House Care Home were of good character. We found that appropriate pre-employment checks had been completed for all members of staff and where references had not been received appropriate risk assessment had been completed.

All staff at Godolphin House Care Home had completed safeguarding training and information within the home demonstrated that manual handling training for staff was on-going.

We saw that staff had received appropriate supervision since our previous inspection and staff told us that Godolphin House was 'a good place to work', 'it's very relaxed and homely here' and 'I love the banter with people'.

Below is a summary of what we found. The summary is based on information gathered during conversations with people who used the service, relatives, staff and management of Godolphin House Care Home.

Is the service safe?

No. On the day of the inspection we judged the service to be not safe.

The provider had not taken adequate steps to ensure the people employed at Godolphin House Care Home were of good character. Because the manager had not obtained references from the person's last employer. The staff had not received appropriate training and supervision to ensure staff were qualified and supported to be competent to carry out their roles.

Is the service effective?

Yes. On the day of the inspection we judged the service to be effective.

The staff and management ensured appropriate and timely referrals were made to multi professional teams, these included doctors and dentists.

The care plans reflected the current medical and psychological needs of the people living in the home.

Is the service caring?

Yes. On the day of the inspection we judged the service to be not caring.

People told us they were well cared for by staff. Their comments included 'I am getting good care'. We heard staff talk with the people who lived at Godolphin House Care Home in a caring manner.

Is the service responsive?

Yes. On the day of the inspection we judged the service to be responsive.

The service was responsive, we found people were aware of the complaints procedure but had not raised a complaint as they were happy with service they received. People told us 'the carers are good as gold' and their call bells are answered promptly.

Is the service well led?

Yes. On the day of the inspection we judged the service to be well led.

The service had appropriate quality assurance systems in place. We saw survey of the experiences of people who lived at the home had been completed. Staff told us they felt supported by the management team.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered mnager on our register at the time.

The provider had a system in place to ensure training was booked and completed relating to safeguarding people from abuse and protecting their rights. All of the staff we spoke with understood the role of the local authority and how to make a safeguarding alert. All of the staff were confident that if they raised any concerns to the manager these would be acted upon.

Money held for a person living at the home was held securely and records were accurate and up to date.

Each person had a care plan in place which stated their individual needs. People had access to a range of services including hairdresser, chiropodist and GP'S. People who lived at Godolphin House Care Home told us 'We are all getting good care' and the staff were 'very nice'.

The provider did not have a system in place to ensure training was completed relating to safeguarding people from abuse and protecting their rights. The staff we spoke with did not understand the role of the local authority or how to make a safeguarding alert.

Staff were supported to provide care to the people who lived at Godolphin House Care Home.

The views and opinions of the people who lived at the home and/or their representatives were gained to ensure the home was providing a good quality service. Systems were in place to audit the home on a daily basis.