18 April 2023
During an inspection looking at part of 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.