CQC report explained · a residential care home
What the CQC found at HF Trust Gaston House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
HF Trust Gaston House & Dolphin House was rated Requires Improvement; inspectors found safety checks, activity support and management systems were not always reliable.
This was an unannounced focused inspection on 4 and 6 January 2023. One inspector met everyone living at the home, spoke with a resident, relatives and staff, observed care, and checked care, medicine, staffing and management records.
The home was not always safe. Water safety checks and fire alarm checks had not been kept up to date. There was also limited information about managing one person's epilepsy risks, although this was addressed after the inspection. Staffing, safeguarding, medicines and infection control were described positively.
People did not always receive planned, person-centred support. Activities were often arranged as needed rather than regularly, some one-to-one support hours were missed, and communication aids were not always used. Leadership changes and weak quality checks meant known problems had not been dealt with promptly.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, responsive and well-led were rated Requires Improvement. This was a focused inspection, so the other areas were not inspected during this visit.
Consistent staff
People benefited from a stable staff team who knew them and understood how to keep them safe.
“People benefited from a stable and consistent staff team who knew how to keep people safe.” from the report
Medicines
Inspectors found that medicines were given as prescribed by trained staff, with safe ordering, storage, administration and disposal.
“People received their medicines as prescribed from staff who had been appropriately trained.” from the report
Safeguarding
People appeared comfortable with staff. Systems were in place to protect people from abuse, and staff understood their safeguarding duties.
“Systems and processes were in place to protect people from the risk of abuse and staff understood their safeguarding responsibilities.” from the report
Family contact
Relatives said they could visit when they wanted and felt welcome at the home.
“Relatives told us they could visit the home when they wanted and felt welcome.” from the report
Water safety checks
seriousRequired monthly water temperature checks had stopped, and staff did not have a formal risk assessment explaining how to manage the legionella risk.
“This had not been done and records showed these checks had stopped in April 2021.” from the report
Fire safety records
needs fixingWeekly fire alarm tests had not been recorded for several months.
“Weekly fire alarm tests had not been recorded since September 2022.” from the report
Activities and one-to-one support
needs fixingActivities were not planned regularly, some important activities had not been offered since October 2022, and one-to-one support hours were not always provided.
“Activities were completed on an ad-hoc basis rather than being planned as a regular part of people's lives.” from the report
Communication support
needs fixingSome communication aids recommended for people were not always used or known about by staff.
“These were not always used or known by staff.” from the report
Weak oversight
seriousThe provider's audits had identified some problems, but action was not taken quickly enough. This contributed to a breach of the good governance regulation.
“The provider's oversight and governance systems were not always operated effectively in assessing, monitoring and improving the quality and safety of the service provided.” from the report
- 01Have the monthly water temperature checks and other legionella safety measures now been completed and recorded?
- 02Are weekly fire alarm tests currently being completed and checked by management?
- 03How will my relative receive regular activities, including any gym, swimming or community activities that matter to them?
- 04How are one-to-one support hours recorded, and what happens when staff shortages mean they are missed?
- 05Which communication aids and profiles does my relative need, and how do you make sure every staff member uses them?
This was an unannounced focused inspection of Safe, Responsive and Well-led; the other key questions were not inspected during this visit and the overall rating was calculated using previous ratings. This explanation was written from the published report of 8 February 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, October 2018
Rated Good overall, but inspectors found the home was not always responsive to people's social needs and rated this area Requires Improvement.
Inspectors carried out a comprehensive, announced inspection on 4 September 2018. They observed care, reviewed care plans, medicines records and quality checks, and spoke with the manager, staff and relatives.
The home was rated Good for safety, effectiveness, caring and leadership. People were protected from abuse and avoidable risks. Staff supported people with medicines, health care, nutrition and daily choices. Inspectors saw kind and respectful relationships between people and staff.
The responsive rating was Requires Improvement. Staffing pressures and people's different social preferences meant some people did not always get the support they wanted to go out or take part in community activities. Some care and communication records also needed updating.
Risk management
The home identified risks in the home and community and had plans to help staff reduce them. Staff also understood how to report suspected abuse.
“Risks were identified and risk management plans were in place to support staff to mitigate the risks of harm people may face at home and in the community.” from the report
Kind relationships
Inspectors saw people looking comfortable and relaxed with staff. Staff understood people's communication, preferences and need for privacy.
“People had developed positive relationships with the staff supporting them.” from the report
Health support
People were supported to use health services and had health action plans. Staff worked with a range of health and social care professionals when needs changed.
“People were effectively supported to access healthcare services and received ongoing healthcare support.” from the report
Quality checks
The manager completed monthly checks against the five CQC questions. These checks fed into an improvement plan with timescales for action.
“The audit identified areas where improvements needed to be made, the timescale for implementing the improvements and where evidence would be located once the action had been completed.” from the report
Staffing pressure
needs fixingVacancies and sickness meant staff regularly worked extra hours. On the inspection day, staffing was below the planned level in both houses, which reduced the attention people received.
“Sometimes we do work with just two staff. I wouldn't say it was unsafe, but it does impact on people quite a lot because they don't get our full attention.” from the report
Missed activities
needs fixingSome people who wanted to go out did not always receive their planned extra support because staff also needed to support people who stayed at home.
“Once a month at least, they don't get those extra hours.” from the report
Incomplete support plans
needs fixingThere was not enough written guidance for staff about supporting one person's behaviour. Some responses were known by staff but had not been added to the care plan.
“However, talking with staff there were clearly some responses to situations or people that were already known, which had not been incorporated into the care plan.” from the report
Window restrictors
seriousTwo types of window restrictors were being used, and one type could be overridden. The concern was escalated and action was being taken after the inspection.
“We found one type did not meet health and safety standards because they could be easily overridden by people.” from the report
- 01How many staff vacancies remain now, and how will you make sure staffing levels support both people who stay at home and people who want to go out?
- 02How often will my relative receive their planned one-to-one support, and how will missed hours be recorded and made up?
- 03What written strategies are now in place for people whose behaviour may challenge themselves, others or staff?
- 04How are people with limited verbal communication involved in choosing meals and activities?
- 05Have all the window restrictors been replaced or made safe, and what was the completion date?
This was a comprehensive inspection of the whole service and all five key questions; the overall rating remained Good, while responsiveness changed from Good to Requires Improvement. This explanation was written from the published report of 12 October 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 HF Trust Gaston House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Goodstayed GoodSafe: GoodResponsive: Requires improvementWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Registered with the Care Quality Commission on 22 September 2014.
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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