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.
- Safe?
- Good
- People felt safe, staffing levels were sufficient, and staff recruitment and safeguarding checks were in place. Medicines, risks, accidents, the environment and infection control were managed safely.
- Effective?
- Good
- Care plans reflected people's needs and choices. Staff were trained and supported, people received suitable food and drinks, and staff worked with health professionals when needed.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were involved in decisions about their care and could choose how to spend their time.
- Responsive?
- Good
- Care was personalised and adapted when people's wishes or needs changed. People could follow their interests, keep in touch with others and raise concerns.
- Well-led?
- Good
- The home had approachable leaders, staff felt supported, and systems were used to monitor care and make improvements. The deputy manager and provider provided day-to-day management while the registered manager was absent.
What inspectors found, September 2019
Garden House was rated Good overall, with safe, kind and personalised care found across all five areas.
This was an unannounced, planned inspection on 10 September 2019. Two inspectors spoke with nine people living there, four care staff, the deputy manager and the provider. They observed care and checked three people's care records, medicines records and medicines storage.
Inspectors found people felt safe and well cared for. Staff were described as trained, competent and familiar with people's needs. People were supported to make choices, keep their independence, maintain relationships and take part in activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published on 13 January 2017.
People felt safe
People told inspectors they felt safe and staff came quickly when help was needed. Risk assessments, staffing and safeguarding arrangements supported this.
“If I press the bell they come quickly. It makes you feel safe knowing there is always someone here.” from the report
Kind relationships
Inspectors found warm relationships between people and staff. People were treated as individuals and felt at home.
“They are like family. Nothing is ever too much trouble.” from the report
Choice and independence
People chose their routines, activities, meals and how much support they wanted. Their care plans recorded their preferences.
“I make all my own decisions, what time to get up, go to bed, what to do in the day, everything.” from the report
Personalised care
Staff knew people's likes, dislikes and routines. Care was changed when people's needs or wishes changed, including decisions about night-time checks.
“People were treated as individuals and were able to follow their own routines.” from the report
Activities and connections
People could take part in organised activities, trips and social events, or follow their own interests. They could also keep in touch with family and friends.
“We have a list of what is on every week. You can choose to take part or not.” from the report
Open management
The provider and deputy manager were visible and approachable. Staff said they were well supported and quality checks were used to identify improvements.
“The deputy manager and provider were described as very open and easy to talk with.” from the report
Inspectors raised no specific concerns in this report.
- 01Who is currently responsible for day-to-day management, and how is cover arranged when the registered manager is absent?
- 02How will you assess and review my relative's risks, care plan and night-time support if their needs change?
- 03How do you make sure medicines, including as-required medicines, are given and recorded safely?
- 04What activities, outings and opportunities for independence would be available for my relative?
- 05How would my relative or family raise a concern, and how would you tell us what action had been taken?
This was an unannounced planned inspection covering all five key questions; all ratings remained Good from the previous inspection. This explanation was written from the published report of 27 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
Rated Good; inspectors found safe, kind and responsive care, with some policies and medicines checks needing attention.
Inspectors visited on 29 November 2016 without notice and continued the inspection on 1 December 2016 with notice. They spoke with people living in the home, relatives, staff and managers. They reviewed care files, staff records, medicines, complaints, audits and other documents, and observed care and a mealtime.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable care plans and risk assessments, safe medicines systems, kind interactions and care that reflected people's choices and changing needs.
The report says the home had improved since the previous inspection in August 2015. Earlier problems with staff recruitment, safe care, consent and management records had been addressed. Inspectors still identified some areas to improve, including Mental Capacity Act training and policies, an emergency contingency plan, an out-of-date safeguarding policy and one medicines recording error.
Enough staff
Rotas showed that shifts were covered and reflected the home's stated staffing levels. People and relatives said staff were available when needed.
“There were enough staff to support people.” from the report
Safe care planning
Care plans included people's risks and preferences. Risk assessments were regularly reviewed and staff understood the measures needed to keep people safe.
“Risk assessments were completed, regularly reviewed and up to date.” from the report
Kind and dignified care
Inspectors saw staff listening, offering reassurance and supporting people at their own pace. Staff respected privacy and dignity.
“We observed positive interactions between people and staff throughout our visit.” from the report
Personalised activities
Activities and trips reflected people's interests and memories. People could choose whether to take part.
“Activities were linked to people's likes and dislikes which were reflected in their care files.” from the report
Improved leadership
The management team worked alongside staff and used audits and incident reviews to monitor care and identify learning.
“Quality monitoring audits were completed by the management team.” from the report
Mental Capacity Act training and policy
needs fixingStaff had some understanding of the Mental Capacity Act, but specific training had not been provided and there was no local policy. The manager said these would be arranged.
“Staff had some understanding of the principles linked to MCA however specific training had not been delivered and there was no local policy in place.” from the report
Emergency planning
needs fixingThe home did not have a contingency plan covering events such as fire, gas leaks, flooding, utility failures or break-ins. The manager said one would be written.
“The service did not have an emergency contingency plan in place which could be used in situations such as fire, gas leaks, floods, failure of utilities and break ins.” from the report
Safeguarding policy
needs fixingStaff had safeguarding training, but the written policy was out of date and did not include the newer Care Act principles or clear contact details.
“The home's safeguarding policy which was not up to date and did not include reference to the new Care Act principles or give clear contact details.” from the report
One medicines error
seriousOne person's medicine had been taken from the Sunday pack instead of the Tuesday pack, although the medicines record said it had been given. Management sent a reminder to staff and planned to discuss the issue in supervision.
“We checked two people's blister packs and found that one person's medicine had been taken from the Sunday that week and not the Tuesday.” from the report
- 01What action has been taken to provide Mental Capacity Act training to all staff?
- 02Is there now a local Mental Capacity Act policy, and how is staff understanding checked?
- 03Has the emergency contingency plan been completed, and when was it last tested?
- 04What checks are now used to prevent medicines being taken from the wrong day's blister pack?
- 05Has the safeguarding policy been updated with current principles and clear contact details?
This was an inspection of the overall quality of the service and covered all five CQC questions, with checks on care, medicines, staffing, records, complaints and management systems. This explanation was written from the published report of 13 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 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 8 March 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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