CQC report explained · a residential care home
What the CQC found at Gingercroft Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2023
Rated Inadequate and placed in special measures; inspectors found serious safety, care and management failures.
This was an unannounced inspection on 26 September 2023. Two inspectors spoke with people living in the home, a relative, staff and the registered manager. They reviewed care records, medicine records, staff files, safety records and management checks.
Inspectors found that people were not always protected from abuse or other avoidable harm. Risks, medicines, staffing, recruitment and infection control were not managed consistently. Care plans did not always give staff enough guidance about people's health needs. Inspectors also found poor checks on the quality and safety of the home.
The home was rated Inadequate overall. Safe and well-led were rated Inadequate, while effective was rated Requires Improvement. Caring and responsive were not given ratings in this report. The home was placed in special measures, and the provider must give an action plan and will be monitored.
People said they felt safe
Although inspectors found serious safety failures, people told them they felt safe and described staff as kind and friendly.
“I am happy here. I feel safe, staff help us. They [staff] are nice, and friendly.” from the report
Kind staff approach
Inspectors observed staff asking for consent before supporting people. People also described staff as kind and gentle.
“They [staff] are kind and gentle.” from the report
Choice of food and drinks
People were generally satisfied with the food and said they could choose something else if they did not like the menu.
“We have lovely choices and fresh food which is nice.” from the report
Some safety checks were completed
Inspectors found that checks of gas, electrical and fire detection systems had been carried out.
“Checks, such as on gas, electrical and fire detection systems were made to ensure they remained safe for people to live there.” from the report
Manager was open to feedback
The registered manager accepted the concerns raised by inspectors and the local authority and had started some improvements.
“The registered manager was open to feedback and open to working to resolve the issues we and the local authority identified during our visits.” from the report
Safeguarding failures
seriousPotential abuse incidents were not always identified, investigated or referred to the local safeguarding authority. This left people at risk of continuing abuse.
“People were not protected from the risk of abuse. Systems were not in place to identify instances of abuse.” from the report
Unsafe risk and medicines management
seriousCare plans did not always address choking, falls or distressed behaviour. There were also gaps in recording an antibiotic, so inspectors could not be sure it was given as prescribed.
“This meant we could not be sure the person received their medicines as prescribed.” from the report
Staffing and recruitment checks
seriousSome staff had not had all the required employment, identity and background checks. Staff were also not always positioned where they could see people or respond to requests for help.
“There were periods of time where communal areas were unattended, and people were left with no staff and no way of summoning assistance independently.” from the report
Consent and legal rights
seriousDecision-specific mental capacity assessments were not always completed. A relative's legal authority to make decisions had not been checked in one case.
“The provider had failed to ensure appropriate decision-specific mental capacity assessments were carried out.” from the report
Poor management oversight
seriousThe home's quality monitoring systems did not reliably identify problems or check that they were fixed. Required notifications were also not always submitted.
“Quality assurance systems in place were not effective at identifying and addressing concerns.” from the report
Building and infection control shortfalls
needs fixingParts of the building needed repair and redecoration. Inspectors also found weaknesses in hygiene arrangements and said a recent COVID-19 outbreak had not been reported externally.
“A recent infection control audit from health professionals identified a large number of actions showing hygiene practices in the home were not always suitable.” from the report
- 01What immediate changes have you made to identify, investigate and report safeguarding concerns?
- 02How are you checking that medicines, choking risks, falls risks and other care-plan risks are managed correctly for each person?
- 03How do you decide how many staff are needed, and how do you ensure communal areas are always supervised?
- 04Have all staff now had complete employment, identity and DBS checks, and what induction and training do new staff receive?
- 05What conditions has the regulator proposed, and what progress has been made on the required action plan?
This was an unannounced inspection prompted by concerns about oversight and safety; inspectors assessed Safe, Effective and Well-led, while Caring and Responsive were not rated in this report. This explanation was written from the published report of 16 December 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, March 2022
Inspected but not rated; inspectors found good COVID-19 infection control and visiting arrangements.
This was an announced, targeted inspection on 22 February 2022. Inspectors looked at infection prevention and control, visiting arrangements and whether COVID-19-related staffing pressures affected care.
The home had COVID-19 risk assessments for people and staff. It had systems for safe visiting, testing, isolation and cohorting. Inspectors also found enough personal protective equipment, regular cleaning and up-to-date infection control guidance.
The home was inspected but not rated. This report does not give an overall quality rating or ratings for most areas of care.
COVID-19 risk planning
The home had individual COVID-19 risk assessments for people and staff, intended to reduce infection risks.
“People using the service and staff had their individual risks assessed in relation to COVID 19.” from the report
Infection control
Inspectors found sufficient PPE, daily cleaning schedules and checks of bedrooms and frequently touched areas.
“There was sufficient PPE and we saw daily cleaning schedules and checks were undertaken of all bedrooms and touch points.” from the report
Visiting arrangements
The home had a system for safe visiting, including checks of visitors’ COVID status and temperatures. It had also built a visiting pod.
“The provider had built a visiting pod for people to use.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection control and visiting arrangements are in place now?
- 02How would you isolate or cohort people if someone developed an infection?
- 03How do you manage staffing pressures when staff are absent because of COVID-19?
- 04How often are bedrooms and touch points cleaned, and how is this checked?
- 05What arrangements are available for visits, including visits from people who cannot use the visiting pod?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated overall. This explanation was written from the published report of 8 March 2022 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 Gingercroft Residential Home
4 rated inspections over 5 years: the service has held its Inadequate rating throughout.
- December 2023Inadequatecurrent ratingSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
Read what inspectors found at Gingercroft Residential Home →
- March 2022Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at Gingercroft Residential Home →
- February 2020Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2019Requires improvementup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2018InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017
Registered with the Care Quality Commission on 25 August 2017.
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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Most charge £980 to £1,230 a week. 85 can care for a couple. 10 years' experience on average.
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