Carr Gate

Updated 11 May 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 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 1 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

Carr Gate 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. Carr Gate is a care home with 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

This inspection was unannounced.

What we did before the inspection

We reviewed all the information we had received about the service since its last inspection in 2018. We requested feedback from stakeholders, including local safeguarding, infection control and commissioning teams. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 5 relatives about their experience of care provided. We gathered feedback from 10 staff members including the registered manager, the regional improvement lead, nurses, senior staff, and care staff. We looked around the building and observed people being supported.

We reviewed a range of records including 8 people’s care plans and risk assessments. We reviewed a variety of medicines records. We looked at 3 staff files in relation to recruitment. We reviewed records relating to the governance in the service, including audits.

We requested additional evidence, including training and incident records and policies following the site visit. We had a meeting with the registered manager and the regional improvement lead during the inspection to discuss queries in relation to risk management and staff training and support.

Updated 11 May 2023

About the service

Carr Gate is a nursing home providing accommodation for up to 65 people, who require personal care. The service provides support to people who have physical and mental health needs and conditions such as dementia. At the time of our inspection there were 45 people using the service.

The home is set out across 2 floors, divided in to 3 units. Each unit has a lounge and dining area. One unit specialises in supporting people with dementia and another is dedicated to nursing care. The home is spacious and has a ‘homely’ environment.

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

Feedback from people, relatives and staff indicated staffing levels impacted people’s experience of care. We found no evidence of harm to people and the registered manager gave us assurances. We have made a recommendation about feedback and practices concerning staffing deployment.

People and relatives told us they felt the care provided was safe. Staff were trained and aware of their safeguarding responsibilities. Recruitment was managed safely. Infection, prevention, and control measures were followed to ensure staff protected people from the risk of infection.

We found medicines were managed safely and risks associated with people’s care were appropriately assessed. We found records associated with people’s care were person-centred. However, at times, historic information or handwritten notes made it difficult to understand the relevant support at the time. The staff had received training in care planning and the provider was monitoring this.

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.

Effective quality and governance processes were in place. Any concerns were investigated, and lessons learnt were shared with staff. The service worked with the other professionals ensure people's care was effective.

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 requires improvement (published 14 December 2018). At our last inspection we recommended the registered manager completed weekly audits of medicines. At this inspection we found the registered manager had actioned this and taken steps to improve their medicines management.

Why we inspected

We received concerns in relation to staffing levels, poor internal communication and management of incidents and risk. As a result, we undertook a focused inspection to review the key questions of safe 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 the service can respond to COVID-19 and other infection outbreaks effectively.

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 from requires improvement to good based on the findings of this inspection.

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

Recommendations

We have made a recommendation about the provider continuing to review feedback around staffing levels and their staff deployment.

Follow up

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