Gilwood Lodge

Gilwood Lodge is a residential nursing home providing personal and nursing care for up to 47 people. Some of whom may be living with dementia, mental health, physical or sensory impairments. The home has two floors with lift access to the first floor. At the time of our inspection there were 44 people using the service.

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

The registered manager assessed people's individual needs prior to living at the service. Individual risk assessments were in place to highlight areas of risk however we found some gaps in the information. We have made a recommendation about 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.

People and their relatives told us that the service was safe. Comments included, “I think the staff keep [my relative] really safe and secure.” And “The staff keep [my relative] safe. ”Staff interactions with people were positive and staff knew people well. When a safeguarding concern was identified the registered manager took immediate action. Staff, relatives, and residents we spoke with consistently told us there was enough staff. One person told us, “There are always enough staff when we need them.” People were given their medicines by staff who were trained to do so. we were assured by the infection prevention and control procedures in place and observed staff following infection prevention practices. We found recruitment was safe and all the staff files we viewed contained the relevant information.

People told us the service was well managed. There were effective systems in place to monitor the quality of the care provided. We found the management team receptive to feedback and keen to improve the service. The registered manager worked with us in a positive manner and provided all the information we requested.

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 21 May 2018).

Why we inspected

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

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, which will help inform when we next inspect.

Gilwood lodge is a care home providing personal care to support up to 47 people, some of whom may be living with dementia, mental health, physical or sensory impairments. The home has two floors with lift access to the first floor. Rooms are en suite and there are sufficient bathroom and toilet facilities. At the time of our inspection visit there were 44 people who lived at the home.

We found the following examples of good practice.

¿ The registered manager had excellent methods of monitoring people’s health. For example, they set up monthly virtual meetings with the GP to review each person’s medication, ongoing progress and health. The designated clinical lead also had responsibility for care planning and checking people’s continuing needs. This had a positive impact on people’s lives.

¿ The management team created different safe spaces in following guidance around visiting. Alternatives included electronic communication and window visits to retain essential family contact.

¿ Staff had various training to strengthen their awareness of the pandemic and manage people’s safety. Multiple PPE stations had good stocks of equipment, which staff used effectively.

¿ The registered manager retained a separate wing to manage outbreaks if this need arose. They had plans that followed relevant guidance, such as having a core staff team delivering care. The management team demonstrated good practice by retaining two empty beds for such events.

¿ The management team followed strict infection control auditing every month, whilst carrying out visual checks throughout each day. Where issues were identified, these were addressed promptly.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 28 February 2017. Breaches of legal requirements were found in relation to record keeping and ensuring sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed to meet people’s needs. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements.

We carried out an unannounced focused inspection on 20 July 2017 and found the provider had followed their plan and legal requirements had been met. The service was rated 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 ongoing 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.

There was a registered manager in place. 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 who lived at the home and their visitors told us they were happy with the care provided at the home and staff were caring and compassionate. Comments received included, “I visit at various times every day and always find the same standards of care. Excellent.” And, “The staff are very pleasant and caring.”

People visiting the home told us they felt their relatives were safe in the care of staff who supported them. One person said, “I am quite happy [relative] is here and I know they are safe. The staff are wonderful.”

Procedures were in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

The service had sufficient staffing levels in place to provide support people required. We saw staff showed concern for people’s wellbeing and responded quickly when people required their help.

Medication procedures observed protected people from unsafe management of their medicines. People received their medicines as prescribed and when needed and appropriate records had been completed.

We saw there was an emphasis on promoting dignity, respect and independence for people who lived at the home. People told us staff treated them as individuals and delivered person centred care.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place to live. We found equipment had been serviced and maintained as required.

The service had safe infection control procedures in place. People who lived at the home told us they were happy with the standard of hygiene.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care and support had been planned with them. They told us they had been consulted and listened to about how their care would be delivered.

Care plans were organised and had identified care and support people required. We found they were informative about care people had received.

People told us they were happy with the variety and choice of meals available to them. Meal times were relaxed and well managed. People who required assistance with their meal were supported patiently by staff.

People were supported to have access to healthcare professionals and their healthcare needs had been met.

People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

The service had information with regards to support from an external advocate should this be required by people they supported.

People told us staff who supported them treated them with respect and dignity.

People who lived at the home told us they enjoyed a variety of activities which were organised for their entertainment.

The service used a variety of methods to assess and monitor the quality of the service. These included regular audits, resident meetings and satisfaction surveys to seek their views about the service provided.

Further information is in the detailed findings below

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gilwood Lodge on our website at www.cqc.org.uk.

Gilwood lodge is registered for the regulated activities accommodation for persons who require nursing or personal care, treatment of disease and disorder or injury. The home is located in the south shore area of Blackpool close to the promenade. The home has two floors with lift access to the first floor. Rooms are en suite and there are bathroom and toilet facilities on both floors. Lounges and dining areas are also located on both floors. Private car parking facilities are available for people visiting. The service can accommodate a maximum of 47 people and specialises in providing care for people who live with dementia.

The service did not have a registered manager in place. 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.

When we undertook this inspection the service had appointed a new manager. The manager had commenced working at the home and was in the process of completing an application to be registered with the Care Quality Commission (CQC).

At our focused inspection on 20 July 2017 we found that the provider had followed their plan and legal requirements had been met.

We found staffing levels the service had in place were sufficient to provide support people required.

Staff had received training to enable them to support people who challenged the service safely.

Care records had been developed, were informative and enabled us to identify how people were supported with their care. People's weight was being monitored and we found action had been taken where weight loss was identified. Information about how the service supported people who presented behaviour which challenged the service had been developed with clear strategies for staff supporting people who became agitated and distressed.

This is the first inspection at Gilwood Lodge following the new providers registration with the Care Quality Commission (CQC) on 11 November 2016.

Gilwood lodge is registered for the regulated activities accommodation for persons who require nursing or personal care, treatment of disease and disorder or injury. The home is located in the south shore area of Blackpool close to the promenade. The home has two floors with lift access to the first floor. Rooms are en suite and there are bathroom and toilet facilities on both floors. Lounges and dining areas are also located on both floors. Private car parking facilities are available for people visiting. The service can accommodate a maximum of 47 people and specialises in providing care for people who live with dementia. At the time of our inspection visit there were 42 people who lived at the home.

When we undertook our inspection visit the registered manager had recently left the service. 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. The services operations manager told us the service had appointed a new manager who would commence working at the home on 03 April 2017. An Acting Manager was on duty on the day of our inspection.

We found care plans were disorganised and it was difficult to identify how the service supported people who had been assessed as being at risk of losing weight. People’s weight had not always been recorded and we found incomplete records completed by staff monitoring some people’s food intake. Information about how the service supported people who presented behaviour which challenged the service required development. This was because care plans did not provide clear strategies for staff supporting people who became agitated and distressed. The acting manager acknowledged documentation was poor and these were under review when we undertook our inspection visit.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had not maintained accurate, complete and contemporaneous records in respect of each person who lived at the home.

We found staffing levels the service had in place were not sufficient to provide support people required. Some people who lived at the home and their visitors told us the service was often understaffed and sometimes they had to wait a long time when they needed assistance. We observed the lunch time meal in both dining rooms and saw some people who required assistance with their meals did not receive the support they required. This was because there was not enough staff to support everyone who needed help. We saw people sat staring at their meals and others getting up and leaving the dining room having eaten very little.

The services training matrix was dated and it was difficult to establish what training staff had received. During the inspection we noted concerns regarding accurate recording of weight loss and behaviour that challenged the service. The service was unable to evidence appropriate training had been provided to staff in these key areas.

This was breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had failed to ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed to meet people’s needs.

Although a number of people had limited verbal communication and were unable to converse with us, we were able to speak with six people who lived at the home. We also spoke with three people visiting their relatives. People told us they were happy and well cared for and felt safe living at the home. One person said, “No issues with my care. The staff are very good I just wish there were more of them.”

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care.

We looked at the recruitment of three recently appointed staff members including one registered nurse. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

The service had checked when recruiting nurses that they were registered with the nursing and midwifery council (NMC). These checks had been repeated regularly to ensure nursing staff were still registered with the NMC and therefore able to practice as a registered nurse.

We found people had access to healthcare professionals and their healthcare needs were met. One person we spoke with told us how the service had responded recently when they were unwell.

People who lived at the home and their visitors told us they enjoyed a variety of activities which were organised for their entertainment. These were organised individually and in groups.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff spoken with understood their responsibilities to report unsafe care or abusive practices.

The acting manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

We found equipment used by staff to support people had been maintained and serviced to ensure it was safe for use.

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals.

We found medication procedures at the home were safe. Medicines were safely kept with appropriate arrangements for storing in place.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy with their care.

The service used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews.

You can see what action we have asked the provider to take at the back of the main body of the report.