CQC report explained · a residential care home
What the CQC found at Gate House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found that routine safety checks had not identified dangerously hot water, and records were not always completed correctly. They were also not clear that an emergency evacuation would be successful.
- Effective?
- Good
- People's needs and preferences were assessed clearly. Staff were trained and supported people with food, healthcare, transfers between services and decisions about their care.
- Caring?
- Good
- People said staff treated them with kindness and respect. Inspectors saw friendly interactions and found that privacy, dignity, independence and personal choices were promoted.
- Responsive?
- Good
- Support plans were personalised and reviewed. People had key workers, took part in activities and community life, and were supported to maintain relationships with family and friends.
- Well-led?
- Good
- Inspectors found a positive culture, low staff turnover and good relationships between staff and people. The manager used meetings, feedback and records to monitor and improve the service.
What inspectors found, April 2020
Gate House rated Good overall; inspectors found kind, effective care but safety checks needed improvement.
This was an unannounced inspection on 10 and 11 March 2020. Inspectors spoke with people living in the home, staff and a visiting professional. They reviewed care, medicine and staff records, as well as safety and quality records.
People said they liked living in the home and felt safe. Inspectors saw kind and respectful care. Staff supported people with medicines, healthcare, food, activities, relationships and independence. The home was clean and staff used infection control measures properly.
The main shortfalls were in safety monitoring. A hot water tap was dangerously hot, but existing checks had not found this. Inspectors were also not assured that everyone could be evacuated safely in an emergency. The overall rating stayed Good, but Safe fell from Good to Requires Improvement.
Kind relationships
Inspectors saw friendly and caring interactions. People said staff treated them with respect.
“We observed friendly, natural interactions between people and staff during our inspection.” from the report
Personalised support
Care plans reflected people's preferences and choices. People had regular protected time with a designated key worker.
“People's support plans were personalised and included how they wished their assessed needs to be met.” from the report
Independence and community life
People were supported to cook, work, attend activities and maintain friendships outside the home.
“People are supported to do things, and keep their independence.” from the report
Medicines management
Medicines were stored and administered safely. Records were completed correctly and staff understood the medicines they gave.
“People's medicines were managed and stored safely.” from the report
Dangerously hot water
seriousA shared hand basin tap was dangerously hot and presented a scalding risk. Existing water temperature records had not identified the problem.
“The registered manager checked the temperature of the water and confirmed it was dangerously hot, presenting a scalding risk.” from the report
Safety checks and records
needs fixingWater temperature checks were not detailed enough, and fridge and freezer temperatures were not always recorded correctly. Inspectors recommended reviewing how essential checks were carried out and audited.
“We recommend the provider seek guidance from appropriate sources and review how they conduct, record and audit their essential daily safety checks.” from the report
Emergency evacuation
seriousFire drill records showed that many people did not respond urgently or declined to take part. Inspectors were not clear that everyone could be evacuated safely.
“It was not clear how successful an emergency evacuation of the home would be.” from the report
- 01What action was taken after the dangerously hot tap was found, and how do you now check water temperatures?
- 02How are fridge and freezer temperature records checked for accuracy and completeness?
- 03What changes have been made to help people take part in emergency evacuation drills?
- 04When was the latest external fire safety assessment completed, and what did it require the home to do?
- 05How will you show that the safety improvements identified at this inspection have been completed?
This was an unannounced planned inspection covering all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 17 April 2020 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, September 2017
Gate House was rated Good; inspectors found safe, kind and person-centred care, with staff supervision not always carried out regularly.
This was an unannounced comprehensive inspection on 8 August 2017. Inspectors spoke with people living at the home, staff, the registered manager and visiting health professionals. They reviewed care plans, medicines records, staff records and quality checks.
The home supported seven adults with mental health problems, with five people living there at the time. People said they felt safe and were treated kindly. Inspectors found enough staff, safe medicines management, suitable risk plans and good links with health professionals.
People were supported to make choices, stay independent, keep in touch with family and follow their interests. Their care plans were reviewed and reflected their needs. The main shortfall was that regular one-to-one staff supervision and appraisals were not happening as often as the provider's own procedures required.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as at the previous inspection on 22 May 2015.
People felt safe
People told inspectors they felt safe. Staff knew how to recognise and report abuse, and risk plans gave clear guidance about supporting people's mental health and wellbeing.
“People told us they felt safe living at the service.” from the report
Safe medicines
Trained staff gave medicines safely. Records showed medicines were given as prescribed, stored securely and fully accounted for.
“People continued to receive their medicines safely from trained staff whose competency had been assessed.” from the report
Kind and respectful care
Staff treated people with kindness and respect. People were supported to maintain their dignity, privacy, independence, beliefs and important relationships.
“People continued to be treated well and respected by staff.” from the report
Individual support and activities
Care plans covered people's individual needs and preferences. People were supported to take part in activities, work, education, trips and daily tasks.
“People were supported to follow their interests and do the things they enjoyed.” from the report
Staff supervision was behind
needs fixingRegular one-to-one supervision and appraisals were not happening as often as the provider's procedures required. The manager had a plan to improve this, but records showed staff had received only two one-to-one supervisions each year for the previous two years.
“However, we saw that one-to-one supervision sessions and appraisals were not done regularly in line with the provider's procedures.” from the report
- 01How often do staff now receive one-to-one supervision and appraisals?
- 02How do you check that the planned improvement to staff supervision has been completed?
- 03What training and checks are now in place for staff communication and report writing?
- 04How are people's mental health risks, including signs of relapse, reviewed and updated?
- 05How are people involved in decisions about menus, activities and house rules?
This was an unannounced comprehensive inspection covering all five rating areas and the overall quality of the service. This explanation was written from the published report of 8 September 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 Gate House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 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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