CQC report explained · a residential care home
What the CQC found at Gough House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and said there were enough staff to meet their needs. Inspectors found appropriate safeguarding training, risk assessments, safe medicine management and good infection control.
- Effective?
- Good
- People's needs and choices were assessed and reflected in care plans. Staff supported people with food, healthcare and equipment, and worked with outside health professionals.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors found that privacy, dignity, independence and involvement in care decisions were respected.
- Responsive?
- Good
- Care was adapted to people's preferences, routines and interests. People knew how to complain, and complaints were acted on, but end of life preferences had not been explored.
- Well-led?
- Good
- People, relatives and staff spoke positively about the manager and communication. Quality audits, incident reviews and a clear staffing structure were used to oversee the home.
What inspectors found, July 2019
Gough House was rated Good overall; inspectors found kind, safe and personalised care, but end of life wishes had not been explored.
The inspection took place on 09 July 2019. One inspector and one Expert by Experience visited. They spoke with 10 people, three relatives, six staff and two visiting professionals. They also checked care records, medicine records, staff files and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People said staff were kind, respectful and available. Inspectors found that care was personalised, risks and medicines were managed safely, and people were supported with food, activities and healthcare.
The home had systems for checking quality and learning from incidents. However, there was no evidence that people's end of life preferences had been explored. The overall Good rating means inspectors found the service met the relevant standards at the time of this inspection.
Kind and respectful staff
People and relatives said staff were caring, patient and friendly. Inspectors found that people's privacy and dignity were respected.
“People told us they received support from staff who were very caring.” from the report
Personalised support
Care plans reflected people's choices and needs. Staff supported people to keep familiar activities and routines, including meaningful tasks and preferred ways of receiving care.
“People told us they received care personalised to meet their needs and that allowed them to retain choice and control.” from the report
Safe care and medicines
People felt safe and staff understood safeguarding. Risks, medicines, creams and infection control were managed safely.
“People felt safe and told us they received care and support from competent staff in a safe way, people said there were sufficient levels of staff to meet their needs.” from the report
Good teamwork and oversight
Staff worked with health professionals to achieve good outcomes. The manager used audits and checks to identify errors and omissions.
“There was a programme of quality audits and checks overseen by the registered manager.” from the report
End of life wishes not explored
needs fixingNo one was receiving end of life care during the inspection, and inspectors found no evidence that people's preferences for this care had been discussed.
“There was no evidence that people's end of life preferences had been explored with them.” from the report
- 01How will you discuss and record my relative's end of life wishes if they want to talk about them?
- 02How often are care plans reviewed with the person and their family?
- 03How would you support my relative's specific dietary, mobility or healthcare needs?
- 04How do you check that staffing levels remain sufficient when people’s needs change?
- 05What activities and daily routines could my relative continue or start at the home?
This was a planned inspection covering the home, the care provided and all five CQC questions; all five ratings remained Good from the previous inspection. This explanation was written from the published report of 24 July 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, January 2017
Gough House was rated Good; inspectors found kind, safe care, with further work needed to make the environment easier for people with dementia to use independently.
Inspectors made an unannounced visit on 6 December 2016. They spoke with almost all 13 residents, a relative, healthcare professionals, staff and the manager. They observed care and looked at medicines, meals, care records, staff checks, training and other records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, good support with food and drink, respectful care and activities that reflected people's interests.
The home had improved since the previous inspection in October 2015. Staff now understood the Mental Capacity Act and Deprivation of Liberty Safeguards better, and quality checks had improved. However, the manager was new and had not yet registered with the CQC, and further environmental improvements were needed for people living with dementia.
Kind and respectful care
Staff spent time with people, used humour and affection appropriately, and supported privacy, dignity and choice.
“Staff treated people with kindness and respect. Staff cared about people's well-being and worked hard towards reducing people's anxieties.” from the report
Safe staffing and risk support
Inspectors found enough staff to meet people's needs. Staff understood individual risks and followed guidance to reduce them.
“There were sufficient staff available to meet people's needs.” from the report
Improved rights and decision-making
Staff understood the Mental Capacity Act and recorded best-interests decisions when people could not make particular decisions themselves.
“The manager and staff had received training in the MCA and displayed an understanding of its principles.” from the report
Good leadership improvements
The new manager had improved care, records, activities and quality monitoring within five weeks of starting.
“In this short period of time this manager had worked hard to improve on the care being provided for people and provide staff with strong and approachable leadership.” from the report
Personalised activities
The home offered group and individual activities, including music, quizzes, trips and activities linked to people's past interests.
“People took part in organised activities within the home, such as music therapy, visiting musicians, carol services and quizzes.” from the report
Environment for people with dementia
needs fixingHighly patterned carpets and limited signs could make it harder for some people to find their way around independently. Inspectors recommended getting advice about improving the environment.
“We found that a large number of communal areas had highly patterned carpets which did not support people's independence, as these can be difficult for people with dementia or people with vision problems to navigate.” from the report
Medicine recording gap
minorA gap was found in the recording of medicines for the previous day. Staff checked that the medicine had been given and acted immediately, but families may want to ask how recording is now checked.
“On the day of our inspection the senior on duty in the morning had identified a gap in the recording of medicines for the day before.” from the report
Manager registration
needs fixingThe previous registered manager had left, and the new manager had not yet registered with the CQC at the time of the inspection.
“A new manager had started at the service five weeks prior to our inspection but had not yet registered with the CQC.” from the report
- 01What changes have you made to the patterned carpets and signs since the inspection to help people with dementia move around independently?
- 02Has the new manager now registered with the CQC, and who is legally responsible for running the home while this is completed?
- 03How do you now check that every medicine administration is recorded correctly?
- 04How far have you progressed with the new, more detailed care plans and personalised activity plans?
- 05How do you check that any conditions attached to Deprivation of Liberty Safeguards authorisations are being met?
This was an unannounced comprehensive inspection covering all five quality areas and the overall rating, with detailed checks of four people's care records. This explanation was written from the published report of 12 January 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 Gough House
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 7 February 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
23 live-in carers within about an hour of North Somerset
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 £1,050 to £1,320 a week. 19 can care for a couple. 12 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.