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 were protected from abuse and avoidable harm. Risks were assessed and managed, staffing and recruitment checks were in place, and medicines were generally given safely, although one stock discrepancy was found.
- Effective?
- Good
- Care plans were detailed and regularly reviewed. Staff had appropriate training and support, and people received food, drinks and healthcare support suited to their needs.
- Caring?
- Good
- Staff knew people well and treated them with kindness, dignity and respect. People were involved in care decisions and encouraged to be independent.
- Responsive?
- Good
- Care was personalised and flexible. Care plans described people's routines, moods, abilities and preferences, and people were offered activities and ways to share their views.
- Well-led?
- Good
- Inspectors found strong leadership, an open culture and effective quality checks. There was no registered manager at the time, but an acting manager and deputy manager were running the home with provider support.
What inspectors found, June 2019
Garden House was rated Good overall, with kind personalised care and strong leadership, although one medicines record discrepancy was found.
This was an unannounced, planned comprehensive inspection on 3 May 2019. Inspectors spent time with eight people, observed care, spoke with staff and healthcare professionals, and reviewed care records, staff files, medicines, accidents, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people received personalised care from staff who knew their needs, preferences and interests. People were treated with kindness, encouraged to make choices, and supported to stay independent.
People were protected from abuse and risks were assessed. Medicines were generally managed safely, food and drinks met people's needs, and staff had suitable training and support. The home had a positive culture and systems to monitor quality.
The previous inspection in September 2016 rated Responsive as Requires Improvement. This inspection found that area had improved to Good. The home did not have a CQC-registered manager during this inspection, but an acting manager was in post and working towards registration.
Personalised care
Care plans gave staff detailed information about people's personalities, moods, routines and preferences. Staff knew people well and adapted support to them.
“People's care plans contained highly personalised information which detailed how they wanted their care to be delivered.” from the report
Kind and respectful staff
Inspectors saw patient, positive interactions. Staff promoted people's happiness, dignity and independence.
“All interactions we saw were respectful, patient and kind.” from the report
Good staff support
Staff received induction, training, supervision and appraisals. Inspectors found staff skilled and knowledgeable about people's needs.
“There was a comprehensive training programme to ensure staff had the necessary skills to meet people's individual needs.” from the report
Positive leadership
The home had an open culture where people, relatives and staff were asked for their views. Quality checks were used to monitor care and safety.
“The service had a clear, positive and open culture that was shared both amongst the management team and care staff.” from the report
Improved responsiveness
Responsive care had improved since the previous inspection, when this area was rated Requires Improvement. The new inspection rated it Good.
“People's needs were met through good organisation and delivery.” from the report
Medicines stock discrepancy
needs fixingInspectors found that the recorded amount of one medicine did not match the stock available. The deputy manager carried out a full audit, found the cause and introduced changes to reduce the risk of it happening again.
“On the day of inspection we identified a discrepancy between one medicine amount in stock and the amount recorded.” from the report
No registered manager
minorThe home did not have a CQC-registered manager during the inspection. An acting manager was in place and working towards registration.
“The service did not have a manager registered with the Care Quality Commission.” from the report
More staff being recruited
minorThe home said it was looking to recruit more staff after new people had moved in. This was intended to provide more one-to-one time.
“The acting manager told us they were looking to recruit more staff to the service as new people had recently moved in.” from the report
- 01Has the acting manager now applied for CQC registration, and who is responsible for the home until that process is complete?
- 02What caused the medicines stock discrepancy, and what checks are now carried out to prevent a repeat?
- 03Has the planned recruitment of more staff been completed, and how much one-to-one time can people now receive?
- 04How are people's care plans reviewed when their needs, moods, diets or preferences change?
- 05How are relatives involved in care reviews and in sharing concerns about the service?
This was an unannounced comprehensive inspection of all five key questions, carried out on 3 May 2019. This explanation was written from the published report of 6 June 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, November 2016
Garden House is rated Good overall; inspectors found safe, kind care, but activities and some care records needed improvement.
Inspectors visited on 22 and 27 September 2016. The first visit was unannounced. They spoke with all 22 people living at the home, staff, visitors and healthcare professionals. They also observed care and checked records, medicines, staffing and the building.
The home was rated Good for safety, effectiveness, caring and leadership. Inspectors found kind staff, safe medicines, suitable training, good healthcare support and systems to check the quality of care.
The home was rated Requires Improvement for being responsive. Activities and social interaction were limited. Some care plans did not contain the latest information, although reviews were being completed and the manager was taking action.
Kind and patient staff
Inspectors saw staff treating people with kindness and patience. People appeared relaxed and happy with staff.
“Staff were observed to be kind and patient, supporting people in an easy, unrushed and pleasant manner.” from the report
Safe medicines
Medicines were stored securely and given by trained staff. Records showed medicines were given on time and checks were carried out.
“People were supported to receive their medicines safely and on time.” from the report
Good staff training
Staff had training in areas including dementia care, medicines, first aid and moving and transferring. Their practice and development were also checked.
“There was a comprehensive staff training programme in place and a matrix indicated when updates were needed.” from the report
Good healthcare support
People saw healthcare professionals when needed. Professionals told inspectors staff contacted them promptly and followed advice.
“They said staff took advice and followed it through efficiently.” from the report
Open management
Staff described an open culture and felt able to raise concerns or suggest improvements. The manager used audits to monitor care.
“There were systems in place to assess, monitor, and improve the quality and safety of care.” from the report
Limited activities
needs fixingThere were some group activities, but few individual plans based on people's interests and life histories. Inspectors said opportunities for social interaction were limited.
“There were no individual activity plans to ensure people had meaningful activities to promote their wellbeing.” from the report
Care plans not always up to date
needs fixingReviews contained newer information, but this was not always transferred to the main care plans. This could leave staff without the latest information about a person's life or needs.
“This meant staff did not have the most up to date information with which to care for the person.” from the report
Privacy and dignity
needs fixingStaff discussed people's care needs during a handover in the lounge. Large stocks of continence products were also kept in bedrooms, which could reveal people's needs to visitors.
“People's dignity was not always upheld.” from the report
Supper-time staffing
needs fixingStaff said supper time could be busy because care staff also had to serve food and help people eat. Inspectors recommended keeping staffing levels under review.
“Staff told us they thought there were enough staff on duty generally, but that supper time could sometimes could be rushed.” from the report
Mental Capacity Act records
needs fixingSome capacity assessments were not linked to a specific decision. Some best-interest decisions were made by the manager alone rather than involving all relevant people.
“Best interest decisions should involve the views of as many relevant people as possible, including relatives and health and social care professionals.” from the report
- 01What individual activities are now planned for each person, based on their interests and life history?
- 02How do you make sure changes found during care plan reviews are transferred to the main care plans?
- 03How is staffing arranged at supper time, and has this reduced pressure on care staff?
- 04How are Mental Capacity Act assessments and best-interest decisions now completed and recorded?
- 05How are continence products stored, and where are staff handovers held to protect privacy?
This was a planned inspection of the overall service, with the first day unannounced, and all five CQC questions were rated. This explanation was written from the published report of 1 November 2016 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 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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