The Gatehouse provides accommodation and personal care for up to 28 older people, some of whom are living with dementia. The home is set in its own grounds near to the beach, a cafe and close to the town. The accommodation comprises a large lounge, dining room and conservatory which overlooks the garden. A new extension had been completed which provided further bedrooms and a second lounge. At the time of our inspection there were 22 people living at the home.The inspection was unannounced and was carried out on 7 and 10 August 2018 by one inspector.
The Gatehouse is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.
The management of people’s medicines required improvement. The storage of some medicines was confusing and some people’s medicines were unaccounted for. We could not be assured that people received their medicines as prescribed.
People’s rights were protected because staff understood the principles of the Mental Capacity Act (MCA) 2005 and consent, although annual reviews of MCA assessments were a little confusing. Deprivation of liberty safeguards had been submitted to the local authority for authorisation when required.
Recruitment procedures were safe and ensured only suitable staff were employed to work at the home. There were sufficient staff deployed to meet people’s needs and keep them safe.
People were protected from abuse. Staff understood how to identify and report abuse if they suspected abuse was taking place.
Staff received training, supervision and appraisal to support them in their roles and to provide them with the required skills, knowledge and competencies.
Risks associated with people’s health, safety and welfare had been identified and assessed, and guidance was in place to help staff to reduce those risks.
Staff followed infection prevention and control procedures which minimised risks of cross infection. Effective cleaning routines ensured the home was clean and tidy.
Emergency evacuation procedures were in place and staff understood what to do in the event of an emergency. Health and safety checks, including fire safety were carried out regularly.
People had access to health care services when required and were supported by staff to maintain their health and wellbeing. People were offered a choice of food and drink that met their preferences and dietary needs.
Staff were kind and caring and treated people with dignity and respect. People were encouraged to maintain important relationships with family and friends who could visit at any time.
Staff empowered people to make choices and maintain their independence. People took part in a wide range of activities in line with their interests.
People and their relatives were involved in planning their care. Care plans provided clear guidance for staff in how people wanted to receive their care.
The provider met the Accessible Information Standards. Staff used a range of communication and provided information to people in a way they could understand, such as signs and gestures which helped them to make informed choices.
Systems were in place to monitor and assess the quality and safety of the service. People and relatives were offered opportunities to feedback their views about their care and this was used to improve the service.
Complaints procedures were available and displayed throughout the home in picture format. People knew who to speak to if they wanted to complain, although the home had not received any complaints.
There was a positive, supportive and open culture within the home. Staff felt supported by the registered manager who was approachable and involved them in the development of the service.
The registered manager understood their responsibilities under the Health and Social Care Act 2008, including submitting notifications of events as required to the Commission.
We last inspected the service in May 2016 when we found no concerns and rated the service as good. At this inspection we found one breach of regulations.