CQC report explained · a residential care home
What the CQC found at Garden House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2019
Rated Good overall, but inspectors found weaknesses in leadership, medicines records and the monitoring of staff culture.
This was an unannounced planned inspection on 18 and 30 July 2019. Inspectors spoke with people living at the home, relatives, staff, managers and a health professional. They also checked care plans, medicines records, staff recruitment records and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, clean surroundings, kind care, personalised support, activities and systems to protect people from abuse. They also found that staff supported people with food, drink, healthcare and decisions about their care.
The Well-led rating was Requires Improvement. Medicines records had several shortfalls, and the home's checks had not identified these problems. Staff gave mixed feedback about the culture, and inspectors recommended that the provider keeps this under review. The provider also had not followed the correct procedure after a safeguarding incident, although it changed its procedures afterwards.
Enough staff
Inspectors found enough staff were working to meet people's needs, and recruitment checks were carried out safely.
“There were sufficient staff deployed to meet people's needs.” from the report
Kind and respectful care
People and relatives said staff were kind and promoted dignity. Inspectors saw people being supported with care and respect.
“People and relatives told us people were treated with kindness and their dignity was promoted.” from the report
Personalised support
Care plans recorded people's needs, choices and communication requirements. People could choose how to spend their day.
“People received personalised care which met their needs.” from the report
Activities and social contact
The home had an activities coordinator and supported people to follow hobbies, go out and maintain social links.
“People were supported to pursue their hobbies both inside and outside of the home.” from the report
Action after inspection
The home provided separate moving and handling equipment where needed after inspectors raised a possible infection risk.
“Following our inspection, the registered manager ensured that each person had their own hoist sling and moving and handling sheet where required, to reduce the risk of cross infection.” from the report
Medicines records
needs fixingInspectors found several shortfalls in recording medicines. The provider's quality checks had not found these problems.
“We identified several shortfalls with the recording of medicines” from the report
Staff culture
needs fixingSeveral staff raised concerns about practices and the culture. Inspectors recommended continued checks to make sure the culture stayed open, positive and person-centred.
“We received mixed feedback from staff about the culture at the service.” from the report
Weaknesses in quality checks
needs fixingManagement checks did not identify medicines recording problems or some staff practices, including shared moving and handling equipment.
“We identified shortfalls with medicines recording which the provider's quality monitoring system had not identified.” from the report
Safeguarding procedure
needs fixingThe provider did not follow the correct procedure after a safeguarding incident. It said lessons had been learned and changed its procedures.
“The provider had not carried out the correct procedure following a safeguarding incident.” from the report
Dementia communication skills
minorSome staff were less skilled than others at communicating with people living with dementia. Additional dementia training was under way during the inspection.
“We noticed that some staff were more skilled in communicating with people living with dementia than others.” from the report
- 01What changes have been made to medicines recording since the inspection, and how is this now checked?
- 02What dementia care training has been completed, and how do managers check that staff can communicate effectively with residents living with dementia?
- 03What action has been taken in response to staff concerns about the home's culture?
- 04How does the provider now check for staff practices that management may not otherwise see?
- 05What procedure is now followed when there is a safeguarding incident?
This was a planned, unannounced inspection covering all five CQC questions; the previous overall rating was Good, but Well-led had fallen from Good to Requires Improvement. This explanation was written from the published report of 24 September 2019 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, January 2017
Garden House was rated Good; inspectors found safe, kind and personalised care, with only a minor concern about background noise.
Inspectors visited on 16 November and 2 December 2016 without giving notice. They spoke with people, relatives and staff, observed care, and checked care records, recruitment files and other safety and quality records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Medicines, staffing, safety checks, nutrition and safeguarding arrangements were found to be suitable.
People were treated kindly and with dignity. Care plans were detailed and personalised. Activities, healthcare and support with food and drink were available.
The inspectors noted that noise from a radio, television and laundry music could sometimes be unsettling or make it difficult to focus. The manager said this would be addressed and monitored.
Improved medicines management
Inspectors found safe systems for ordering, storing and giving medicines. Records were complete, and staff competency was checked.
“Medicine records were complete and up to date.” from the report
Kind and dignified care
Staff were observed speaking politely and reassuringly. They maintained people’s privacy and dignity during personal care and meals.
“We observed staff providing care and attention to people on both days of the inspection.” from the report
Personalised care plans
Care plans included people’s life history, preferences, communication methods and signs of pain or distress. This helped staff respond to individual needs.
“Person centred care plans were in place and these were reviewed and updated regularly.” from the report
Good food and nutrition support
People were supported with meals and drinks, and special diets were provided. Weight loss and the risk of malnutrition were monitored.
“Where people were at risk of malnutrition, specialist advice was sought.” from the report
Quality monitoring
The manager carried out regular checks covering areas such as medicines, care plans, accidents, equipment and infection control. The report says action was taken when checks found shortfalls.
“Regular audits to monitor the quality of the service were carried out.” from the report
Background noise
minorInspectors found that a television and radio could make it difficult to focus. Music from the laundry could also be heard in a main corridor and might not have been suitable for people living there.
“music playing in the laundry for staff could be heard in the main corridor upstairs, and may not always be suitable for people living there” from the report
- 01What changes were made to reduce or monitor background noise from radios, televisions and laundry music?
- 02How are medicines checked now, following the improvements identified since the 2014 inspection?
- 03How often are care plans reviewed, and how will my relative’s communication methods and preferences be recorded?
- 04How will you assess staffing levels if residents’ care needs change?
- 05What activities and community trips are currently available, and how often can residents use them?
This was an unannounced inspection of the home’s overall quality and all five CQC areas, including observations, discussions and checks of care and management records. This explanation was written from the published report of 26 January 2017 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 Garden House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 2011.
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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