About the service Gilby House Nursing Home is a care home registered to provide accommodation and personal and nursing care to 22 people with mental health needs. At the time of our inspection, 21 people lived at the service.
People’s experience of using this service and what we found
Areas of the service had not been properly maintained which meant people were not living in a well-cared for environment. Maintenance issues made it difficult to effectively clean the service. We found areas of the premises were dirty which placed people at risk of developing infections.
Not all risks to people’s safety and wellbeing had been identified and mitigated. Governance systems had failed to identify the shortfalls we found, which placed people at risk of harm and of receiving a poor-quality service.
People’s medicines were administered safely, and care plans contained appropriate guidance. Systems were in place to protect people from the risk of abuse. Safe recruitment checks were completed, and staff were allocated to people when they needed more support.
People’s needs were met by skilled and appropriately trained staff who worked closely with relevant professionals. People were supported with their own routines and care plans and their dietary needs were met.
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.
People were supported by caring staff who helped people to take part in activities they enjoyed. The management team supported and made time for people using the service and staff. People and staff were included in developing the service and were kept informed of changed to the service.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 14 November 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement and has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 4 and 6 September 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led which contain those requirements.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains requires improvement. This is based on the findings at this 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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gilby House Nursing Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to ensuring the safety of the premises, infection control and quality assurance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.