CQC report explained · a residential care home
What the CQC found at Garlands Residential Care Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2019
Rated Requires Improvement; care was safe, effective and caring, but records and oversight still needed improvement, and the home was no longer in Special Measures.
Inspectors visited on 5 and 6 August 2019. The first day was unannounced. They spoke with people, relatives, staff and a healthcare professional, and checked care, medicine and staff records.
The home had improved since the previous inspection. Safe, effective and caring were rated Good. Earlier problems with fire safety, equipment, cleanliness, medicines, consent and dignity had been addressed.
Responsive and well-led were rated Requires Improvement. Fluid records, nutritional supplement records and skin records were not always complete or up to date. Audits had not found or resolved these problems. The home was still in breach of Regulation 17, but it was no longer rated Inadequate or in Special Measures.
Safety improvements
Problems with fire risks, premises, equipment and cleanliness found at the previous inspection had been addressed. Medicines were stored and given safely by trained staff.
“People were protected from abuse and avoidable harm.” from the report
Kind and respectful care
People and visitors consistently described staff as caring and kind. Staff respected privacy, offered choices and encouraged people to remain independent.
“Without exception, people and visitors told us staff were caring and kind.” from the report
Food and mealtime support
People were offered food choices and discreet help when needed. Inspectors saw patient support with eating and a meal adapted to one person's needs.
“People were offered a choice of menu. Staff provided verbal prompts and supported people to eat where required.” from the report
Activities and involvement
People could take part in activities and trips. Meetings and the 'resident of the day' process gave people and families opportunities to comment on care.
“Details of the daily activities within the home were displayed in the reception.” from the report
Incomplete care records
seriousFluid records were not always completed promptly. Nutritional supplements were not consistently recorded on fluid charts, and skin records were not updated to show whether problems had improved or worsened.
“This placed people at risk of harm. This was a continued breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008” from the report
Checks did not find problems
seriousThe home had introduced more audits, but they had not identified or resolved the record-keeping problems. Some actions from care plan audits had no evidence of completion.
“However, these audits had not identified or addressed the shortfalls we noted with peoples records and the lack of gas safety check for the gas drier and cooker.” from the report
Fire drill coverage
needs fixingNot all staff had completed a recent fire drill. The manager said this would be dealt with promptly.
“Of the16 staff listed, 12 staff had not completed a recent drill.” from the report
- 01How do you now check that fluid records are completed throughout the day and that nutritional supplements are recorded on them?
- 02How are body maps and skin records kept up to date, and who checks that follow-up actions have been completed?
- 03What has been done to make sure all staff complete fire drills?
- 04How do your audits now identify and resolve gaps in care records?
- 05How are people's communication needs being met following the manager's plan to learn about the Accessible Information Standard?
This was a planned inspection of the whole care home, including premises and care, and it considered all five CQC questions. This explanation was written from the published report of 4 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, February 2019
Garlands Residential Care Home Limited was rated Inadequate and placed in special measures; inspectors found serious safety and management failures.
Inspectors visited the home without warning on 30 and 31 October 2018. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, staff files and management records.
They found serious risks involving fire safety, equipment, medicines, infection control and risk assessments. Some care records were inaccurate or incomplete. People's dignity and legal consent were not always respected, and verbal complaints were not properly recorded or acted on.
The home was rated Inadequate overall. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement. The home was placed in special measures, meaning CQC expected significant improvement and said it would keep the service under review.
Staffing levels
Inspectors found there were enough staff on duty and saw people's needs responded to promptly.
“There were sufficient staff on duty to meet people's needs.” from the report
Kind approach
Relatives said staff were caring and kind. Inspectors also found that staff spoke about people in a caring way and knew them well.
“Relatives told us the staff were caring and kind.” from the report
Staff support
Staff supervision and annual appraisals had improved since the previous inspection.
“Each of the staff we spoke with told us they were now receiving regular management supervision and annual appraisals had been implemented.” from the report
Activities
The home offered activities such as films, crafts, reminiscence and armchair exercises. One-to-one time was offered to people who preferred to stay in their rooms.
“People were supported to engage in a range of activities.” from the report
Medicines
seriousSome medicines were not given as prescribed. Guidance for medicines given when needed or in variable doses was missing.
“Medicines were not always administered accurately and in line with the prescriber's instructions.” from the report
Risk assessments and records
seriousRisk assessments did not always reflect people's current needs, and care records lacked important detail. Records did not show that nutritional supplements were always provided as prescribed.
“People's care records were not always sufficiently detailed or reflective of people's current needs, information within individual care plans was sometimes conflicting.” from the report
Dignity and choice
seriousInspectors saw a person left exposed during a hoist transfer. People were not always told what food they were being served or offered a choice of drink.
“People were not always served meals and drinks in a way which respected their personal preferences and choices.” from the report
- 01What immediate changes have been made to the fire risks, including the gaps in the ceilings and cluttered basement corridor?
- 02How are medicines, including as-required and variable-dose medicines, now checked and given safely?
- 03How are risk assessments and care plans kept up to date when a person's needs change?
- 04How do you record and act on verbal complaints, including concerns about laundry?
- 05How are mental capacity assessments, best-interest decisions and lawful consent recorded?
This was an unannounced inspection of all five key questions, including observations, discussions and checks of care, medicines, staffing and management records. This explanation was written from the published report of 8 February 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.
Every inspection of Garlands Residential Care Home Limited
5 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- September 2019Requires improvementcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Garlands Residential Care Home Limited →
- February 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at Garlands Residential Care Home Limited →
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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At least 100 live-in carers within about an hour of Kirklees
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 86 can care for a couple. 11 years' experience on average.
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