Garson House Care Home

Updated 4 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one Inspector.

Service and service type

Garson House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Garson House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post. There was also another manager appointed who was involved in the day to day management of Garson House Care Home. We have referred to them in this report as the service manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

We reviewed additional information we held about the service, this included previous inspection reports and statutory notifications. A statutory notification contains information about certain incidents and events the provider is required to notify us about by law.

During the inspection

We spoke with 6 members of staff which included the service manager, a representative of the provider and care staff. We spoke with 4 people who lived at the service and observed some interaction between people and staff.

We reviewed a range of records, including peoples’ care records, staff recruitment files, records relating to safety checks including fire safety and accident and incident records. We also reviewed medicines records and records relating to monitoring and quality assurance. Following our site visit we received feedback from 1 healthcare professional.

Updated 4 May 2023

About the service

Garson House is a residential care home for 13 people with conditions associated with old age including dementia. There are some bedrooms on the ground floor, but most bedrooms are on the first floor with access via a passenger lift. Communal lounges and the dining area are all located on the ground floor. The home is in the middle of a small town and so access to local shops and cafes is available. At the time of our inspection there were 12 people living in the service.

People’s experience of using this service and what we found

Following our last inspection, we imposed conditions on the provider's registration which required them to complete a selection of monthly audits and report their findings to CQC. This was because we identified people were at risk of receiving unsafe or inappropriate care as care records did not always reflect their current needs and safety monitoring was not always completed. We also identified risks due to poor environmental management.

The provider had worked closely with the local authority and the service manager had received significant support around implementing a good governance framework. There had been improvements around the management of the service environment and financial investments had been made. The new arrangements were currently being embedded into the service to ensure they were fully effective.

People told us they felt safe at the service and staff knew how to identify and report concerns. People received their medicines when they needed them, however although there was no impact to people, we identified improvements were still needed around the management of medicines. The service manager had elected to delegate the medicines audit out as opposed to completing the audit themselves. This had resulted in an audit being completed inaccurately and had not identified the minor issues we found relating to medicines. We have made a recommendation about the management of medicines.

People’s risks were now managed through an electronic care planning system which the service manager was implementing. There was now a formal system to review incidents and accidents to reduce risks to people. The service was clean and there were now systems to audit the cleanliness of the environment. The service worked well with other health professionals to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Improvements had been made around Deprivation of Liberty Safeguards (DoLS) applications and compliance with the requirements of the Mental Capacity Act 2005. The provider had sought advice and guidance following our recommendation.

There were new governance systems in operation to ensure the health, safety and welfare of people using the service and others. Auditing of care records, environmental risks and Mental Capacity Act 2005 documentation had been implemented and was being embedded into the service. The provider had now notified CQC in full about any significant events at the service in line with regulatory requirements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Inadequate (published 3 November 2022). The provider sent us monthly reports in line with conditions imposed on their registration.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the service sought advice and guidance from an accredited source to ensure the Mental Capacity Act 2005 and relevant supporting legislation was well embedded in the service. At this inspection we found improvements had been made in this area.

This service has been in Special Measures since 3 November 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from Inadequate to Requires Improvement based on the findings of this inspection.

Enforcement and Recommendations

We have made a recommendation about the management of medicines.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.