CQC report explained · a nursing home
What the CQC found at The Garden House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe care, suitable risk information, trained staff and effective infection control. They also found medicines temperature checks were not always consistent, some call bells took over 10 minutes to answer, and one safeguarding referral had not initially been made.
- Effective?
- Good
- People received training-supported care, balanced meals and help to access healthcare. Inspectors noted that some mental capacity assessments were not always held centrally.
- Caring?
- Good
- This key question was not inspected during this visit, so no current rating was given in the report.
- Responsive?
- Good
- This key question was not inspected during this visit, so no current rating was given in the report.
- Well-led?
- Good
- The manager had quality checks, an improvement plan and regular meetings with residents, relatives and staff. The service responded to issues raised during the inspection and continued to monitor areas needing improvement.
What inspectors found, August 2023
The Garden House was rated Good; inspectors found safe, effective and well-led care, but identified medicines, call bell and safeguarding recording issues.
This was an unannounced inspection on 12 June 2023. Inspectors spoke with 14 people, 5 relatives and 14 staff. They reviewed 9 care plans, 2 staff files, audits and other records, and observed care.
The home was rated Good overall for the areas inspected: Safe, Effective and Well-led. Inspectors found enough staff, suitable training, detailed care plans, access to healthcare and systems for checking the quality of care.
The inspection was prompted by monitoring activity and concerns about medicines, staffing and whether people were receiving enough care and support. Inspectors found some medicines temperature checks were incomplete, some people experienced delays with call bells, and one incident had not initially been referred to safeguarding. The safeguarding referral was made after inspectors raised it, and the enquiry was later closed.
Care information
Care plans included important information about people's mobility, health conditions and support needs. Inspectors found people were receiving the care and support they needed.
“People's care plans contained important information relating to their support needs such as health conditions and mobility needs.” from the report
Trained staff
Staff received induction, training, supervision and support to develop their skills. Staff said they felt supported and valued.
“People were supported by staff who received training, supervision and an induction.” from the report
Healthcare access
People could access healthcare when needed. The GP visited weekly, and referrals were made to other health professionals.
“Weekly GP visits were conducted and referrals were made to speech and language therapists and physiotherapy teams when required.” from the report
Resident involvement
Residents and relatives could give feedback through meetings, coffee mornings, surveys and direct contact with the manager. The manager also carried out daily walk-arounds.
“Resident and relative's meetings were held quarterly.” from the report
Medicines checks
needs fixingMedicines were stored safely, but temperature checks were not always recorded consistently. There was also no recorded optimum temperature to compare the checks against.
“Medicines were stored safely although temperature checks were not always consistently in place and there was no recorded optimum temperature for what staff were checking temperatures against.” from the report
Call bell delays
needs fixingSome people said they sometimes waited more than 10 minutes for their call bells to be answered. The manager said staffing deployment needed improvement and would continue to be reviewed.
“People raised with us during our inspection at times there was over a 10 minute delay in answering their call bell.” from the report
Safeguarding referral
seriousAn incident that might have involved neglect or abuse had not been referred to the local safeguarding team before the inspection. The manager made a retrospective referral, and the safeguarding enquiry was later closed.
“Prior to our inspection we were informed of an incident which could have been the result of neglect or abuse. No safeguarding referral had been made.” from the report
Fire drill
needs fixingThere had been no recent fire evacuation drill since 2021 when inspectors visited. A fire drill was completed after the inspection.
“Although no recent fire evacuation drill had been conducted in the home since 2021.” from the report
Laundry storage
minorOne laundry cupboard was untidy, with clean laundry on the floor and close to a light. Inspectors said this could pose a fire risk.
“One laundry cupboard was found to be untidy with clean laundry on the floor.” from the report
- 01What improvements have you made to call bell response times, and what are the current response times on each unit?
- 02How are you reducing care staff vacancies, and how do you make sure agency staff know each person's needs?
- 03How are medicine storage temperatures recorded now, and what temperature range do staff check against?
- 04What changes have been made since the safeguarding referral mentioned in the report?
- 05When was the most recent fire evacuation drill, and how often are drills now planned?
This was an unannounced inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected during this visit, and the overall rating remained based partly on earlier ratings. This explanation was written from the published report of 3 August 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, May 2018
The Garden House was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors made an unannounced, comprehensive visit on 27 and 28 March 2018. They spoke with people living there, visitors, staff and managers. They observed care and medicines being given, and checked care records, medicines, recruitment, training, complaints and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff at the time, safe medicines management, clean surroundings, suitable training and kind care. People were supported with their choices, health needs, meals, activities and personal routines.
The previous inspection in February 2017 rated the service Requires Improvement. It found breaches about consent and Deprivation of Liberty Safeguards. At this inspection, inspectors found the required improvements had been made and the legal requirements were being met.
Improved legal safeguards
The home had addressed the earlier problems with consent and restrictions. Inspectors found that capacity assessments, best-interest decisions and DoLS arrangements were being handled properly.
“At this visit, we found sufficient actions had been taken and the legal requirements were being met.” from the report
Safe medicines
Medicines were given according to people’s needs and preferences. Records and checks were in place, including for medicines given when needed.
“Medicines were given safely and in accordance with people's individual needs and preferences.” from the report
Kind and respectful care
Inspectors saw staff being patient, warm and friendly. People’s privacy, dignity, relationships and personal preferences were supported.
“Throughout the two days of our visit, we observed people being treated in kind, caring and respectful ways.” from the report
Personalised support
Care plans included people’s backgrounds, preferences and support needs. People could choose where to spend time, what to eat and which activities to join.
“People received a service that was based on their personal needs and wishes.” from the report
Responsive management
The home listened to feedback and used audits to make changes. This included improving meal temperatures and increasing staffing in an area where call bell response times had increased.
“Where shortfalls were identified, improvement actions were taken.” from the report
Pressure equipment checks
needs fixingTwo pressure-relieving mattresses were not set correctly for the people’s weights. The home corrected this during the visit and said it had introduced stronger checks.
“We noted two pressure relief mattresses where the pressure setting according to the person's weight were not set correctly.” from the report
Care record accuracy
needs fixingSome records were unclear or inaccurate, including records about a pressure ulcer and the reasons for changing dressings. Senior staff took immediate action.
“The records were not clear in that the wound description was not accurate on one occasion” from the report
Fewer weekend activities
minorPeople generally liked the activities, but some said there was less to do at weekends and on bank holidays. Inspectors also saw fewer people from the dementia area joining group events.
“there was not so much to do at weekends or on bank holidays” from the report
Staff vacancies
minorThere were staff vacancies and agency workers were used to cover some shifts. Inspectors found staffing sufficient during the visit.
“There were staff vacancies and a recruitment programme was in place.” from the report
- 01How do you now check that each pressure-relieving mattress is set correctly for the person using it?
- 02What checks make sure pressure ulcer records and dressing changes are complete and accurate?
- 03How do you make sure staff always knock before entering rooms, particularly in the Sundials area?
- 04What activities are available at weekends and bank holidays, including for people living in Sundials?
- 05How many staff vacancies are there now, and how often are agency staff used?
This was an unannounced comprehensive inspection of all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 4 May 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 The Garden House
5 rated inspections over 9 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Goodstayed GoodSafe: Requires improvement
- January 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 18 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.
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