CQC report explained · a residential care home
What the CQC found at Little Gaynes Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2023
Rated Requires Improvement; inspectors found gaps in assessments, legal safeguards and quality checks, although people had good access to food and healthcare.
This was an unannounced focused inspection on 23 May 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicines and management records. They looked at effective care, leadership and medicines safety, rather than carrying out a full review of every area.
The home supported people with food, healthcare, training and a suitable environment. People and relatives described an open atmosphere and said concerns were dealt with. The home had also improved its layout and signs since the previous inspection.
However, assessments and care plans did not fully record some equality and diversity needs. Conditions on some Deprivation of Liberty Safeguards authorisations were not always followed. Medicines records and guidance had gaps, and quality checks did not identify these problems. The overall rating changed from Good to Requires Improvement. Effective and well-led were both rated Requires Improvement, while safe was inspected but not rated.
Food and drink
People were offered meal choices, and staff knew about individual dietary needs. People told inspectors they enjoyed the food and received help when needed.
“People were offered a choice of meals and the menu was reflective of people's culture.” from the report
Access to healthcare
People could see healthcare professionals when needed. The report says the GP visited weekly, and other professionals were involved.
“The GP visited the home on a weekly basis and was called as needed.” from the report
Improved environment
The home had acted on the previous recommendation about its layout. Clearer signs had been added to help people find their way around.
“These issues had been addressed. Changes had been made to the premises and clearer signage was in place.” from the report
Positive atmosphere
People, relatives and staff described the manager and the home positively. People could raise views through meetings and surveys.
“People and relatives also spoke positively about the registered manager and culture at the service.” from the report
Incomplete assessments
seriousAssessments and care plans did not fully cover needs linked to equality and diversity, including ethnicity, sexuality and religion. This was a breach of Regulation 9.
“The provider had failed to carry out a comprehensive assessment of people's needs.” from the report
DoLS conditions not always met
seriousSome legal authorisations had conditions, such as medicine reviews with a GP, which had not been completed. This was a breach of Regulation 11.
“Some people had DoLS authorisations which had conditions attached to them. These were not always met.” from the report
Weak quality checks
seriousAudits did not identify the problems with care plans, DoLS conditions or medicines. This was a breach of Regulation 17.
“Systems for monitoring and improving care were not always effective.” from the report
Medicines guidance
needs fixingOne medicine record had not been updated after a change, and guidance was missing for some medicines given as required. The provider sent evidence of steps taken after the inspection.
“However, there was no guidelines in place about when to administer these medicines.” from the report
Limited choice about routines
needs fixingOne person said night staff required them to go to bed by 10pm and get up at 6am, despite asking for different times. The provider said it had looked into this after the inspection.
“I have asked to stay up but they say bed now.” from the report
- 01How have you updated each person's assessment and care plan to cover equality and diversity needs?
- 02How do you now check that every condition on a person's DoLS authorisation is completed and recorded?
- 03What has changed in the medicines records and guidance for medicines given as required?
- 04How do your audits now identify problems with care plans, DoLS conditions and medicines?
- 05How will you make sure people can choose their own bedtimes and getting-up times?
This was a focused inspection of Effective and Well-led, plus the medicines part of Safe; the other areas were not reviewed and their previous ratings were used for the overall rating. This explanation was written from the published report of 26 July 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 2019
Rated Good overall; inspectors found kind, safe care, but the service was not always effective.
This was an unannounced, planned inspection. The inspector reviewed care records, medicine records, staff records, rotas, training and safety records. They spoke with nine people, five relatives, nine staff members and three health and social care professionals.
Inspectors found that people were safe and treated with kindness and respect. Staff understood people's risks, medicines were generally managed safely, care was personalised, and people were supported to stay independent. Families and professionals spoke positively about the home and its management.
The overall rating was Good. Safe, caring, responsive and well-led were rated Good. Effective was rated Requires Improvement because staff did not all understand one person's health condition, the lunchtime experience was poor during the visit, and parts of the building and information were not accessible enough for everyone.
People felt safe
Staff understood how to protect people from abuse and manage individual risks. Staffing levels and recruitment checks were also considered suitable.
“Staff knew how to report abuse and to keep people safe from potential harm and had received training in this area.” from the report
Kind and respectful care
People were treated with compassion, dignity and respect. Staff supported people emotionally and encouraged independence.
“We saw people received emotional support and staff approached them in a compassionate way.” from the report
Personalised support
Care was based on people's preferences, including their favourite food and drinks. People and relatives were involved in care planning and reviews.
“People and their relatives told us the service provided personalised care and support.” from the report
Positive leadership
The management was viewed positively by people, relatives, staff and professionals. The home sought feedback and worked with other services.
“We found clear systems in place to audit the overall running and development of the service.” from the report
Staff knowledge
needs fixingNot all staff had been trained about one person's specific health condition and could not explain it to inspectors. The report says training was assigned after the inspection.
“Staff were not able to tell us about this condition and records confirmed not all staff had received training in this.” from the report
Poor lunchtime experience
needs fixingInspectors saw a 25-minute wait before food was served and limited interaction from staff. One person who was disorientated did not receive enough help with their meal.
“There was a 25-minute wait for people between being sat down to eat and being served their food.” from the report
Difficult areas to navigate
needs fixingSome doors and changes in floor level were not clearly marked. This could disorientate people, particularly those living with dementia or sensory needs.
“Some areas were not clearly marked and it was difficult to distinguish where floor levels changed or what doors led to what rooms.” from the report
Information was not accessible to everyone
needs fixingThe home was not following the Accessible Information Standards. This meant some people might not have understood how to complain or access information about their care.
“This meant that all people might not know how to raise a complaint.” from the report
- 01What training have all staff now completed about residents' specific health conditions?
- 02What changes have been made to make mealtimes more supportive and reduce waiting?
- 03Which changes have been made to mark floor-level changes and doors more clearly?
- 04How do you now make care information and complaints information accessible to people with dementia or communication needs?
- 05How often are management checks now carried out, and how are issues followed up?
This was an unannounced planned inspection covering the premises, care and all five CQC questions. This explanation was written from the published report of 27 March 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.
Every inspection of Little Gaynes Rest Home
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- July 2023Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodstayed GoodEffective: Requires improvementWell-led: Good
- October 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
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.
- March 2011
Registered with the Care Quality Commission on 31 March 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.
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