CQC report explained · a residential care home
What the CQC found at The Gouldings
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Several individual risks were not fully assessed. Monitoring after an unwitnessed fall was not completed as required, and the effectiveness of some as-required medicines was not recorded consistently.
- Effective?
- Good
- People's outcomes were consistently good and feedback supported this. Staff had the training and support needed, and people were helped with health care, nutrition and independence.
- Caring?
- Good
- No rating for Caring is given in the supplied report text.
- Responsive?
- Good
- No rating for Responsive is given in the supplied report text.
- Well-led?
- Good
- The home had a clear management structure, quality checks and an improvement plan. People, staff and external professionals said the home was well managed and that concerns would be listened to.
What inspectors found, September 2021
Rated Good overall; inspectors found kind and effective care, but safety still Requires Improvement.
The inspection took place on 5 and 10 August 2021. One inspector spoke with nine people, 15 staff and four external health or social care professionals. They observed care, checked the building and reviewed care, medicines, staffing, training, accident and management records.
The home was rated Good overall. Effective and Well-led were rated Good. Safe was rated Requires Improvement because some risks were not fully assessed, monitoring after an unwitnessed fall was not done as required, and records about some as-required medicines were incomplete.
Inspectors found enough improvement since the previous inspection for the home no longer to be in breach of Regulation 12 or Regulation 18. However, they identified further improvements needed in risk records, falls monitoring, medicines records and mental capacity processes. The manager took prompt action during the inspection in several of these areas.
Kind and unhurried support
Staff were available, responsive and had time to speak with people. Observations found calm and relaxed interactions.
“There was a relaxed atmosphere in the home and staff had time to chat with people and support them in a calm and unhurried way.” from the report
Staff training
Staff completed relevant training, induction and supervision. Inspectors found staff had the knowledge, skills and experience needed for their roles.
“People received care from staff who had the necessary knowledge, skills and experience to perform their roles.” from the report
Food and health support
People were offered choices and support with individual dietary needs. Staff also helped people access doctors, nurses and other health professionals.
“People were supported to eat a varied and nutritious diet based on their individual preferences.” from the report
Management and improvement
There was a clear management structure and regular quality monitoring. The manager acted promptly when inspectors identified issues.
“The provider had comprehensive quality monitoring and assurance systems comprising of a range of audits, which had been effective in bringing about improvement.” from the report
Infection control
Inspectors were assured about the use of protective equipment, testing, cleaning, visiting arrangements and procedures for new admissions during the COVID-19 pandemic.
“We were assured that the provider was using Personal Protective Equipment (PPE) effectively and safely.” from the report
Incomplete risk assessments
needs fixingSeveral risks were not fully assessed, including risks linked to a urinary catheter, diabetes and blood-clot prevention medicine. The manager added assessments during the inspection.
“However, we found several individual risks had not been fully assessed including, for a person who had a urinary catheter, a person with a diagnosis of diabetes and another person who was receiving a medicine to reduce their risk of blood clots.” from the report
Falls monitoring
seriousA person was not regularly monitored after an unwitnessed fall, as recommended by best practice. The home did not have a post-falls policy or monitoring system in place at the time.
“Records for a person who had had an unwitnessed fall showed that the person had not been regularly monitored as required.” from the report
As-required medicines records
needs fixingFor some as-required medicines, staff did not record whether the medicine had worked. This could leave external professionals without all the information needed to review medicines.
“For some of these, a record was maintained of the effectiveness of administration but for others this had not been recorded.” from the report
Mental capacity paperwork
needs fixingMental capacity assessments and best-interest decisions were missing for some decisions. An application for a formal DoLS assessment had also not been made for one person until after inspectors raised it.
“However, where one person did not have capacity to make decisions, MCA assessments had not been completed for decisions such as medicines and the use of equipment for the prevention of pressure injuries or bed rails to reduce the risk of falling from bed.” from the report
- 01What checks have you completed to make sure every person's risks, including diabetes, catheters and blood-clot prevention medicines, are fully assessed?
- 02How do you now monitor people after an unwitnessed fall, and how do you check that staff complete the records correctly?
- 03How do you record whether as-required medicines have worked, and who reviews these records?
- 04Have all required mental capacity assessments, best-interest decisions and DoLS applications now been completed?
- 05How do your audits check that the improvements identified during this inspection have been sustained?
The report gives ratings for Safe, Effective and Well-led and also considered infection prevention and control; it does not give ratings for Caring or Responsive in the supplied text. This explanation was written from the published report of 14 September 2021 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 2019
Rated Requires Improvement; inspectors found kind, personalised care, but unsafe medicines management and gaps in risk controls and staff training.
This was a planned inspection on 2, 5 and 9 April 2019. Inspectors spoke with people, relatives, staff and a healthcare professional. They also reviewed care records, medicines records, accident and complaint records, and quality checks. Both the residential and community services were inspected.
People generally said they felt safe and received kind, respectful care. Inspectors found that care was personalised, people were encouraged to be independent, and their choices and privacy were respected. The home also worked closely with health and social care services.
However, medicines were not always managed safely. Some risks, including falls, choking and dehydration, were not managed well enough. Not all staff had completed the training they needed, and quality checks had not found these problems. The overall rating was Requires Improvement, with Safe, Effective and Well-led also rated Requires Improvement. Caring and Responsive were rated Good.
Kind and respectful care
People consistently described staff as kind and considerate. Inspectors also saw staff provide reassurance, protect privacy and treat people with dignity.
“People were unanimous when asked if the carers were caring. They all told us they were treated with kindness and consideration.” from the report
Personalised support
Care plans covered people’s individual needs and preferences. Staff supported people to make choices and encouraged them to do as much as possible for themselves.
“People received individualised care which met their needs.” from the report
Promoting independence
The service focused on re-enablement and helping people regain or maintain independence. Staff gave people time and encouragement rather than rushing them.
“The focus of the service was to promote people's independence and to provide a re-enablement service.” from the report
Good partnership working
The home worked closely with health and social care professionals. This supported hospital discharge and helped people access healthcare when needed.
“The service had very close links with local health and social care services and worked in collaboration with all relevant agencies, including health and social care professionals.” from the report
Medicines were not always safe
seriousMedicines records contained gaps and stock counts did not always match what had been recorded. There was no reliable process to record administration times, check storage temperatures or follow up missing medicines.
“Within the residential part of the service medicines were not always managed safely.” from the report
Individual risks were not fully controlled
seriousSome care plans did not explain how risks such as choking or falls should be managed. Fluid intake was not totalled or followed up when it was below the expected amount.
“The failure to ensure risks relating to the safety and welfare of people using the service were assessed and managed were breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Staff training and supervision
seriousNot all staff had completed essential training, including training on medicines and infection control. Some staff had received only one supervision in the year before the inspection, and agency staff did not have a formal induction process.
“Staff had not all received training to give them the necessary skills and knowledge to safely meet people's needs.” from the report
Quality checks missed problems
needs fixingAudits and other checks had not identified the problems found during the inspection. This meant managers did not have effective oversight of several safety and care issues.
“The failure of the provider's quality assurance systems had placed people at risk of not receiving a safe effective service.” from the report
Infection control gaps
needs fixingSome staff had not completed infection control or food hygiene training. Inspectors also found a split laundry bag near clean items and no separate handwashing sink in the laundry room.
“Not all infection control risks were managed safely.” from the report
- 01How do you now check that medicines administration records are complete and that stock levels match the records?
- 02How are falls, choking and dehydration risks assessed, recorded and reviewed after an incident or a change in need?
- 03Which staff have completed medicines, safeguarding, infection control and food hygiene training, and how are their competencies checked?
- 04How do you make sure fluid intake records are totalled and acted on when someone drinks less than planned?
- 05What changes have been made to laundry facilities, handwashing arrangements and infection control checks?
This planned inspection looked at all five key questions and covered both the residential premises and the care provided through the residential and community services. This explanation was written from the published report of 21 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.
Every inspection of The Gouldings
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- September 2021Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 8 November 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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84 live-in carers within about two hours of Isle of Wight
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 £1,010 to £1,230 a week. 68 can care for a couple. 11 years' experience on average.
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“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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