Background to this inspection
Updated
18 March 2022
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 two inspectors, a pharmacy specialist 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 service.
Service and service type
The Gateway Care Home 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, along with the provider, were 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. Inspection activity started on 14 Feb 2022 and ended on 3 March 2022. We visited the service on 23 February 2022. The other dates were spent reviewing information off site.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of 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 us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We observed care and support in communal areas. We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with nine members of staff including the Registered manager, care staff and the activities organiser. We reviewed a range of records. This included four people's care records and multiple medication records. We reviewed a variety of records relating to staff recruitment, supervision and training and management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
18 March 2022
About the service
The Gateway Care Home is a residential care home providing personal and nursing care to older people, people living with dementia and people with physical disabilities. The service accommodates up to 92 people across three separate floors, each of which have separate adapted facilities. At the time of the inspection, two floors were being decorated and refurbished and not in use. Thirty four people were using the service and all were living on the first-floor unit.
People’s experience of using this service and what we found
Improvements had been made since the last inspection which had resulted in better outcomes for people using the service.
Systems for managing medicines had improved although we found some improvements were still needed and made a recommendation to support this.
People told us they received safe care. One person said, “The staff are very good and know how to use the equipment to get me in the bath and such. I am comfortable with them.” A relative said, “I feel (relative) is safe there and has always been cared for.” Risk assessments were in place to support staff in knowing how to manage any identified risks to people. Staff knew the processes to follow to manage any allegations of abuse.
Systems were in place to manage the risk of spread of infection within the home.
Care records reflected people’s needs and what staff needed to do to meet them, although records did not always reflect people’s involvement in making decisions about their care. People’s health care and nutritional needs were well managed.
People were complimentary of the care and support they, or their relatives received. One person said, “I have found the staff kind and caring they never raise a voice or anything.” A relative told us, “Without a doubt we are extremely happy with (person’s) care. The carers are very caring and are like friends to us. We are delighted. We observe a lot whilst we are there, and we think they support (person) really well".
Recruitment processes ensured staff were suitable to work in the care service. Staff were trained and said they felt supported in their roles. They had the required skills to meet people’s needs. People told us they thought there were enough staff and they didn’t have to wait for support.
There was a new registered manager in post. They were following action plans to continue to improve the service. People had confidence in the new manager.
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 this service was inadequate (published 6 August 2021).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since November 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced inspection of this service on 11 May 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The breaches were in relation to assessing and managing risks to individuals, managing medicines safely and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 Inadequate 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 The Gateway Care Home on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.