6 & 13 November 2014
During an inspection looking at part of the service
Geel and Hitchin Court provides accommodation for up to 28 older people who are living with dementia and require nursing care. The building is single storey and has 28 single bedrooms. There were 24 people in permanent residence and one person on a respite stay at the time of our inspection.
This was an unannounced inspection, carried out over two days on 6 and 13 November 2014. During the inspection we spoke with five people who lived in the home, seven visitors, seven staff and the registered manager of the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 service is run.
We last inspected Geel and Hitchen Court on 8 May 2014. At that inspection we found the service was not meeting two of the essential standards that we inspected. These were in relation to staffing levels and care and welfare of people. We found that these concerns had been addressed however there were still some areas for further improvement. At this inspection we found concerns with the medication administration, the management of complaints and how feedback from people who lived in the home and their relatives was managed.
We found that the service had addressed the specific areas of concern in relation to the number of carers on duty at tea time and purchase of equipment. We saw that additional staff were now on duty during the evening meal and early evening. Although people told us that they felt safe in this home, there were times when there was not enough staff to meet people’s needs in a timely way. This impacted on the support that people were provided with at lunch time as this was disorganised and people did not receive support at the time they needed it.
People told us, and we found, that people living at the home were generally well cared for, especially at the end of their lives. However, we also saw that staff interactions with people when they were not giving care or support could be improved as we observed carers sitting in the lounge when they had provided support and not engaging with the people sitting there. We identified that dementia care and support is an area that requires improvement.
The home used safe systems when new staff were recruited. All new staff completed training before working in the home and staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual and told us they would be confident reporting any concerns to a senior person in the home. However, we also found that one potential safeguarding incident had not been recorded and that not all complaints were dealt with by the manager or recorded as having been referred to senior management at head office.
Communications in the home would benefit from improvement as relatives and visitors told us that they do not feel involved and are unaware of their relative’s on-going care or any changes to their condition or circumstances.