CQC report explained · a nursing home
What the CQC found at Gainsborough Hall Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Only infection prevention and control was checked. Inspectors were assured that the home could prevent and manage infections, but the whole Safe question was not assessed.
- Effective?
- Good
- People's needs and choices were assessed, staff were trained, and people received suitable food, fluids and healthcare support. Some oral health risk assessment details were not always reflected in care plans.
- Caring?
- Good
- This question was not inspected during this focused inspection.
- Responsive?
- Requires improvement
- This question was not inspected during this focused inspection.
- Well-led?
- Good
- The home had regular audits and checks, reviewed incidents and encouraged feedback. Relatives were concerned about the high turnover of home managers, although senior managers remained consistent.
What inspectors found, September 2023
Gainsborough Hall Care Home rated Good; inspectors found effective, well-led care, but there was no registered manager and some oral health records needed updating.
This was an unannounced focused inspection on 7 September 2023. Inspectors reviewed information held about the home, spoke with people, relatives and staff, and checked care records, training records and quality checks.
The home was rated Good overall. Effective and well-led were both rated Good. Inspectors found that people and relatives were involved in care planning, staff were trained, food and drink were matched to people's needs, and people were supported to make choices.
The Safe question was inspected only for infection prevention and control, so it was not rated. Inspectors were assured that the home had suitable infection control arrangements. Caring and Responsive were not inspected during this visit, so there are no new ratings for these areas.
There was no registered manager at the time of the visit. Senior managers were providing consistency while a new manager was being appointed. The overall rating stayed Good, the same as at the previous inspection published on 7 October 2022.
Involvement in care
Relatives said they were involved in care planning and that people's choices were considered.
“Relatives told us they were involved and included in care planning conversations.” from the report
Trained staff
Relatives and staff said training gave staff the skills and confidence to support people safely and effectively.
“Staff told us the training and support they received gave them the skills and confidence they needed to carry out their roles and responsibilities effectively.” from the report
Food and nutrition
People could choose their meals and drinks, with extra choices available. Staff monitored weight, food and fluids, and made referrals when needed.
“People were given a choice of what they would like to eat and drink.” from the report
Quality checks
The home used regular audits, clinical checks and incident reviews to identify and act on improvements.
“A programme of regular audits and checks were completed to help ensure any improvements to the quality of service were identified and actioned.” from the report
Oral health records
needs fixingOral health risks were assessed, but the details were not always carried through into people's care plans. The deputy manager said this would be addressed.
“However, the detail in the risk assessments was not always reflected in people's care plans.” from the report
No registered manager
needs fixingThere was no registered manager in post during the inspection. A new manager was being appointed, but the report also records relatives' disappointment about the high turnover of home managers.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01When will the new manager start, and when will their application to become registered be submitted?
- 02How are you keeping care consistent while there is no registered manager?
- 03What action has been taken to make sure oral health risk assessments are fully reflected in care plans?
- 04How will you make sure my relative's food, fluids, weight and dietary preferences are monitored?
- 05When were Caring and Responsive last fully inspected, and what were the findings?
This was a focused inspection of Effective and Well-led, with only infection prevention and control checked under Safe; Caring and Responsive were not inspected and the other ratings carried over from the previous inspection. This explanation was written from the published report of 23 September 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2022
Gainsborough Hall Care Home was rated Good overall; care was safe and kind, but activities and personalised support needed improvement.
Inspectors visited unannounced on 12 and 15 September 2022. They spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicine records, staff recruitment files and management records.
The home was rated Good for Safe, Effective, Caring and Well-led. People were protected from abuse, medicines were generally given as prescribed, staff were trained, and people were treated with kindness and respect.
Responsive was rated Requires Improvement. Some people were not always supported promptly when distressed. Temporary staff did not always know people's backgrounds and interests. There were also missed opportunities for activities and meaningful engagement.
The overall rating improved from Requires Improvement at the previous inspection. The provider had fixed the earlier breaches relating to safe care, complaints and governance. Some improvements were made during this inspection, but the home did not have a registered manager in post and was still recruiting permanent staff.
Safer care planning
Risks linked to diabetes and other health conditions had been assessed and managed more thoroughly than at the previous inspection.
“Thorough risk assessments and emergency plans were now in place to direct staff on what action to take” from the report
Kind and respectful care
People were treated gently and with respect. Staff supported people at their own pace and encouraged independence.
“We observed caring and thoughtful interactions between people and staff.” from the report
Staff training
Staff, including temporary staff, received training relevant to people's care needs.
“Staff had completed the provider's training programme.” from the report
Improved leadership
People, relatives and staff said communication had improved under the new manager. Quality audits and daily checks had been introduced.
“The new manager prioritised the completion of internal quality audits where areas for improvement formed the homes internal action plan” from the report
Complaints handled better
Formal complaints had been acknowledged, investigated and answered appropriately. The provider said it had learned from complaints.
“These had been acknowledged, investigated and responded to appropriately.” from the report
Agency staff lacked personal knowledge
needs fixingTemporary staff generally understood people's care needs but did not always know their background and interests. This could make support less personal.
“Whilst temporary staff understood people's support needs, they had little knowledge of people's background and interests.” from the report
Distress not always managed promptly
seriousSome people showing distress did not always receive a prompt or consistent response in line with their care plan.
“This was not always responded to promptly and consistently in line with their care plan.” from the report
Infection control practice
needs fixingInspectors saw some clinical items disposed of incorrectly and staff sometimes wore face masks under their nose or chin. The manager said further supervision would be arranged.
“on various times throughout the inspection staff were seen wearing their facemasks under their nose or chin.” from the report
Medicines patch checks
needs fixingDaily checks were not being completed to confirm that skin patches containing medicines were still in place. The manager introduced this check during the inspection.
“However, daily checks were not completed to ensure patch medicines were still in situ” from the report
- 01How many permanent staff are now working at the home, and how often are temporary agency staff used?
- 02What activities are available each day, including for people living with dementia who may need sensory stimulation?
- 03How do staff record and respond when a person becomes distressed, and how do you check that care plans are being followed?
- 04How are temporary staff told about each person's background, interests, communication needs and personal preferences?
- 05Has a registered manager now been appointed, and how are the new clinical review meetings being checked for effectiveness?
This unannounced inspection examined all five CQC questions and included infection prevention and control checks; it was prompted in part by concerns about safeguarding, personal hygiene and record keeping. This explanation was written from the published report of 7 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Gainsborough Hall Care Home
5 rated inspections over 4 years: the service has held its Good rating throughout.
- September 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2022Goodup from Requires improvementEffective: GoodWell-led: Good
- February 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2019GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2018
Registered with the Care Quality Commission on 17 August 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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