Gibson's Lodge Limited

Updated 15 July 2022

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.

This was a comprehensive inspection to check whether the provider had made the improvements required in relation to breaches of Regulations 9, 11, 12, 17, 18, 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

The inspection was carried out by two inspectors, a specialist advisor who was a registered nurse and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gibson’s Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager in post registered with the Care Quality Commission. The registered manager and provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We attended monthly meetings with the local authority where some concerns regarding this service were raised.

We reviewed information we had received about the service since the last inspection. We used this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with the operations director who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the quality assurance lead, deputy manager, two members of care staff, a nurse, a domestic worker and the laundry assistant. During the inspection we observed how staff interacted with people who used the service. We reviewed a range of records. This included five people’s care records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, accident and incident forms and audits were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 15 July 2022

About the service

Gibson’s Lodge is a nursing home providing personal care and support to older people many of whom were living with dementia. There were 29 people living there at the time of the inspection. The service can support up to 53 people.

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

The provider had followed their action plan to monitor and improve the service given the concerns we identified at our last inspection. Systems to ensure the care people received was good enough were sufficient. We did not identify any concerns and people were happy with their care. This meant the registered manager had good oversight of the service. The registered manager understood their role and responsibilities and people and staff told us they were good at their job. At our last inspection we found many of the concerns were impacted by the turnover of managers and this had affected staff morale. At this inspection we found the registered manager had brought much needed stability. Staff felt well supported and enjoyed their jobs.

Risks of avoidable harm were reduced because the provider had improved their assessing and risk management processes. Risks such as entrapment in bed rails were reduced as checks were in place and staff received training. Medicines management had also improved and was now safe. When people required medicines to be hidden in their food this was done safely and in accordance with the law. The provider operated safe and effective recruitment practices to ensure staff working with vulnerable people were suitable. This included carrying out the necessary checks such as identification, criminal record checks, work history, right to work in the UK and health conditions.

The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19. The provider carried out health and safety checks of the premises and equipment. Care plans in place were detailed and covered all areas of people’s individual needs and preferences. People were involved in their care planning.

Staff received regular and frequent supervision and appraisal to support them. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider’s policies and procedures supported this practice. The provider carried out decision-specific mental capacity assessments relating to areas including the use of bed rails. Staff understood and met people’s needs and preferences relating to eating and drinking. People received a choice of food which was served hot and in sufficient quantities. People’s day to day healthcare needs were met.

Staff supported people in a caring manner and knew the people they were caring for well. People told us they liked the staff and we observed staff were kind and responsive towards people and treated them with dignity and respect. People were encouraged to be involved in their care. Care was personalised to meet people’s needs and preferences. The provider could provide information to people in alternative formats to meet people’s communication needs if required. The provider investigated and responded to any concerns or complaints and people were encouraged to raise concerns.

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

Rating at last inspection and update

The last rating for this service was requires improvement (28 May 2021, published 21 September 2021) and there were breaches of regulations relating to relation to people's safety, person-centred care, fit and proper persons employed, need for consent, staffing, and good governance. We served the provider with a warning notice in relation to staffing. We served the provider a notice of our decision to require a monthly action plan in relation to the breaches. At this inspection we found the provider had taken sufficient action and were no longer in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating and breaches.

We also 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gibson’s Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.