CQC report explained · a residential care home
What the CQC found at Gorsefield Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2019
Gorsefield Residential Home was rated Requires Improvement; inspectors found kind and effective care but staffing, activities and oversight were not consistently good.
This was an unannounced inspection on 25 March 2019. Inspectors spoke with people, a visitor, staff and the registered manager. They observed care and checked care records, medicines, incidents, training and quality records.
People generally felt safe and were treated kindly. Staff understood people's needs, medicines were usually given as prescribed, the home was clean, and people received support with food, health and personal choices.
However, staffing was not always enough for people's wishes and activities. People sometimes waited for support and did not go out as often as they wanted. The systems for checking staffing and driving improvement were not effective, and this breached Regulation 17.
The overall rating was Requires Improvement. Safe, responsive and well-led were also Requires Improvement. Effective and caring were rated Good. The home had also been rated Requires Improvement at the previous inspection.
Kind and respectful care
People were treated politely and kindly. Staff knew people well and respected their privacy, dignity and choices.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Medication support
Inspectors found that people received their medicines as prescribed. Storage, guidance and stock checks were in place, although one stock record was incorrect.
“We saw staff ensured people had their medicines in line with the prescribed instructions.” from the report
Clean and safer environment
Earlier concerns about infection control, cleanliness and laundry had been addressed. The home was clean and environmental improvements had been made or were under way.
“At this inspection we found the provider had made the required improvements.” from the report
Not always enough staff
seriousPeople sometimes waited for help and said staff were rushed. The manager was used as part of the staffing numbers, reducing the time available to manage the home.
“People told us they did not feel there were always enough staff on duty and that staff were rushed and they sometimes had to wait for their support.” from the report
Limited activities and outings
needs fixingPeople enjoyed some activities, but these were limited by staff availability. People did not go out as often as they wanted.
“People told us they had access to some activities which they enjoyed but this was limited to staff availability and they did not get to go out as often as they would like.” from the report
Weak quality oversight
seriousThe provider did not have an effective system for assessing staffing requirements. Its governance systems had not delivered sustained improvement to a Good rating.
“The provider did not have effective systems to assess staffing requirements in the home.” from the report
- 01How many staff are planned for each shift, and how do you adjust this when people's needs change?
- 02How will you make sure the manager has enough time for management and quality checks rather than being counted as regular care staff?
- 03What activities and outings are now available, and how often can residents go out?
- 04What action have you taken to meet the Regulation 17 breach and improve the overall rating?
- 05How are residents and relatives' involvement in care planning now recorded?
This was an unannounced inspection covering the home, care and all five CQC questions, using observations, discussions and records checked on the inspection date. This explanation was written from the published report of 8 May 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 2018
Gorsefield Residential Home is rated Requires Improvement; inspectors found kind care but weaknesses in medicines, activities and quality checks.
This was an unannounced inspection on 6 December 2017. One inspector and an expert-by-experience spoke with people, relatives, staff and a healthcare professional. They reviewed care files, medicines records, staff records, safety records and quality checks.
The home was meeting the previous staffing breach, and inspectors saw enough staff to meet people's needs at the time. However, staffing needed to be reviewed more systematically as people's needs changed. Inspectors also found problems with medicine handling and storage, infection control, confidential records, mental capacity rights and support with activities.
People were treated with kindness and staff knew them well. Care plans had improved and people were supported to access healthcare. However, the provider's quality checks did not identify or resolve important problems. All five areas were rated Requires Improvement.
Kind and respectful staff
People were treated with kindness and compassion. Staff knew people well and supported privacy, dignity and independence during care.
“Staff clearly knew people well, and understood how to respond to their individual needs and requests.” from the report
Improved care planning
Care plans were individual and included people's routines, abilities, independence and social, spiritual and religious needs. They were generally kept under review.
“We saw people's care plans were individual to them and covered a range of needs, including people's social, spiritual and religious needs.” from the report
Health support
Staff helped people access doctors and other healthcare professionals when needed. Healthcare professionals spoke positively about working with the home.
“People and their relatives told us staff helped people to access healthcare services when they needed to.” from the report
Safeguarding knowledge
Staff understood how to recognise possible abuse and how to report concerns. Recruitment checks included references and enhanced DBS checks.
“Staff had received training in, and understood, their individual responsibilities to protect people from abuse, harassment and discrimination.” from the report
Medicines were not always handled safely
seriousInspectors saw tablets handled without gloves and eye drops stored at the wrong temperature. The home's checks had not identified these problems.
“However, we found the provider's medicine procedures were not always adhered to on a consistent basis.” from the report
Weak quality monitoring
seriousQuality checks recorded repeated actions without showing a clear response. The checks did not identify or resolve several significant shortfalls found during the inspection.
“This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Limited activities
needs fixingPeople did not receive consistent help to take part in enjoyable and stimulating activities. Staff were often busy with other care tasks.
“The support people had to take part in activities needed to be improved, adding, "It could be a lot better.” from the report
Infection control concerns
seriousLaundry had sometimes been taken to staff homes when the washing machine was unavailable. The main lounge carpet was heavily stained.
“The registered manager and staff informed us that, on more than one occasion, they had had to take people's laundry home with them, to wash this in their own homes.” from the report
Choice and confidential information
needs fixingOne person was only offered vegetarian meals despite staff saying they could choose other food. Confidential records were left where people or visitors might access them.
“However, staff and management were not allowing them to make these choices.” from the report
- 01What has changed to make medicine handling and storage consistently safe, including the storage of eye drops?
- 02How do you now review staffing levels when the number of residents or their care needs change?
- 03What activities are currently offered, and how do you make sure each person has regular support to take part?
- 04How are confidential care notes, monitoring charts and handover records kept away from public view?
- 05What evidence can you show that the provider's quality checks now identify and resolve problems promptly?
This was an unannounced comprehensive inspection of the whole service, including accommodation and nursing or personal care, with ratings given for all five key questions. This explanation was written from the published report of 7 February 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 Gorsefield Residential Home
4 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- May 2019Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 15 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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