CQC report explained · a residential care home
What the CQC found at Gateholme
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks were not properly assessed or documented. Inspectors also found infection control problems and some medicine recording and storage issues.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality checks did not reliably identify or resolve problems. Confidential care information was also not always stored appropriately.
What inspectors found, August 2023
Requires Improvement; inspectors found gaps in risk management, infection control and oversight, although people generally felt safe and supported.
This was an unannounced focused inspection. Inspectors visited on 26 June and 3 July 2023, spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home had enough staff and recruitment checks were completed safely. Medicines were mostly given as prescribed, and people said they felt safe and supported. However, some risks were not properly recorded or managed, including choking and hoist use.
Inspectors also found cleaning and food storage problems, including unclean kitchenettes, bathrooms and equipment. Care records were sometimes left in communal areas, and audits had not found or fixed the problems. The home acted immediately on some issues, but the new systems still needed to become established.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. This was a focused inspection, so the other key questions were not inspected and their previous ratings were used when calculating the overall rating.
Enough staff
Inspectors found enough staff to support people in a timely way. Recruitment checks were completed before staff started work.
“There were enough staff available to support people in a timely way. The provider ensured staff were recruited safely.” from the report
Mostly safe medicines
Medicines were generally administered as prescribed. A relative also said they had seen medicines being given safely.
“Medicines were administered as prescribed. However, we found areas which required improvement.” from the report
People felt supported
People told inspectors they enjoyed living at the home and felt supported. Relatives were generally satisfied with the care.
“People told us they enjoyed living at the service and felt staff supported them well.” from the report
Safeguarding awareness
Staff had safeguarding training and understood how to recognise, report and record concerns. Inspectors found a system for safeguarding people from abuse.
“Staff received training in safeguarding and understood how to recognise, report and record any concerns.” from the report
Involvement in decisions
People were supported to attend meetings where they could discuss the home and their care. The home also supported contact with families and community activities.
“People were supported to attend 'Our Voice' meetings where they were supported to speak about the home and the care they received.” from the report
Risk information was incomplete
seriousSome care risks were not properly assessed or recorded. One person at risk of choking had no risk assessment, and information about another person's hoist use was limited.
“One person was at risk of choking but had no risk assessment in place to guide staff.” from the report
Infection control and cleaning
seriousSome bathrooms, kitchen areas, fridges, ovens and food storage boxes were not clean or properly maintained. The home took action, but inspectors said the new processes still needed to become routine.
“We found some areas of the home were not effectively cleaned.” from the report
Management checks missed problems
seriousAudits had not identified or resolved several concerns found by inspectors. The provider needed to review and embed its quality monitoring systems.
“Audits had not been instrumental in identifying or resolving concerns we identified during the inspection process.” from the report
Dignity and prompt personal care
needs fixingStaff were not always quick to respond when people needed personal hygiene support. Inspectors said people's dignity was not always promoted.
“Staff were not always quick to respond when people required support with personal hygiene.” from the report
Medicine checks
needs fixingInspectors found missing opening dates, a warm medicine room and differences in stock balances. The manager acted immediately, but CQC recommended improved medicine audits.
“There were no dates of opening on bottles, medicine rooms were warm and required cleaning and there were some discrepancies with stock balances.” from the report
Confidential records
needs fixingCare documents were sometimes left in communal areas, and confidential information was not always stored in line with data protection requirements.
“Confidential and sensitive information was not always stored in line with the Data Protection Act.” from the report
- 01What risk assessments are now in place for choking and for people who need a hoist?
- 02What evidence can you show that bathrooms, kitchenettes, fridges, ovens and food storage areas are now cleaned and checked?
- 03How are medicine opening dates, room temperatures, cleaning and stock balances checked?
- 04How do you make sure care records are kept confidential and are not left in communal areas?
- 05What changes have been made to ensure people receive prompt personal hygiene support and that their dignity is protected?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 3 August 2023 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, June 2018
Gateholme was rated Good; inspectors found safe, kind and personalised care, with some smaller improvements needed.
This was an unannounced comprehensive inspection on 1 and 10 May 2018. Inspectors spoke with people living in the home, staff, a relative and an advocate. They also observed care and checked care plans, staff files and other records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and supported. Inspectors found enough staff, safe medicines practice, suitable training and care plans tailored to people's needs.
Inspectors found caring relationships and a wide range of activities chosen by people. They also found an open management culture, regular checks and a complaints process. Some epilepsy information was improved during the inspection, while other smaller issues were identified for further attention.
The overall Good rating stayed the same as at the previous inspection. The report says there was no evidence of serious risks or concerns.
Safe medicines practice
Inspectors found that medicines were handled safely, including controlled medicines, and that records and storage checks were in place.
“Medicines were handled safely and people received their medicines as their doctor had prescribed.” from the report
Caring staff
Staff knew people well and inspectors saw compassionate, respectful support. People were involved in decisions about their care.
“Staff were passionate about their job, they were observed delivering care with compassion, and empathy.” from the report
Personalised care
Care plans included people's histories, health needs, preferences and the level of involvement they wanted.
“Each person had a care plan tailored to meet their individual needs which included people's life histories, health action plans and hospital passports.” from the report
Activities and relationships
People were supported to take part in education, work, hobbies, community activities and important relationships.
“Throughout the day it was evident that the service met the needs of people they supported when promoting inclusion and social participation.” from the report
Open management
Staff said they felt valued and the home had regular audits, meetings and feedback arrangements.
“There was an open and transparent culture in which staff felt valued and able to approach the registered manager.” from the report
Epilepsy information
needs fixingTwo people's epilepsy risk assessments did not cover several areas of support or show reviews more often than every 12 months. The plans were updated by the second day of the inspection.
“However, two individuals had epilepsy and although there were epilepsy risk assessments in place, these did not show they had been reviewed more frequently than 12 months” from the report
Support with independence
minorOn one occasion, staff prepared meals that people could have made themselves. The manager said this would be addressed with staff.
“However on one occasion we saw staff preparing people's meals where they could have completed these themselves.” from the report
Noisy meetings
minorA monthly meeting was difficult to hear because of noise. The manager said ways to improve this would be considered.
“it was noted by the inspector to the registered how noisy this was and not everyone could hear what was going on.” from the report
- 01How are the epilepsy risk assessments now being reviewed, and do they cover bathing, cooking, electrical equipment and community activities?
- 02How do staff make sure people do as much as possible for themselves, including preparing meals?
- 03What action has been taken about the steps and narrow corridors affecting wheelchair access?
- 04How have meetings been changed so everyone can hear and take part?
- 05How are staff supported to understand and use each person's preferred communication method?
This was an unannounced comprehensive inspection covering all five key questions, with the overall Good rating unchanged from the previous inspection. This explanation was written from the published report of 12 June 2018 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 Gateholme
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2018Goodstayed GoodSafe: GoodWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 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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