Gresham Care Home

Updated 14 April 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

Two inspectors (one who specialised in medicines) and an Expert by Experience completed this inspection. 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

Gresham 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. Gresham care home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 16 March 2023 when we visited the location, and ended on 31 March 2023 when we gave formal inspection feedback.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people to ask their views on the care they received. We also spoke with the registered manager, operations administrator, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed 4 people's care records. We reviewed medicine administration and associated records for 14 people and spoke with 2 members of staff about medicines.

After the inspection we received further documentation electronically, such as governance audits, supervisions and minutes of meetings. We spoke with 2 healthcare assistants, 1 senior carer, 1 nurse, 4 relatives, and 2 external healthcare professionals.

Updated 14 April 2023

About the service

Gresham Care home is a nursing home providing personal and nursing care for up to 45 people. At the time of our inspection there were 44 people using the service, some of whom were living with dementia. The building comprises a ground and first floor with communal areas that people could access, such as a lounge, dining room, and activity area.

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

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. However, some improvements were required in relation to decisions around the use of CCTV (closed circuit television) monitoring and in relation to covert medicines documentation.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. Staff received training in learning disabilities and autism. There were information folders for staff on various subjects they could access to learn more, and recognise, respect and value differences in people.

People told us that Gresham care home was a safe place to live and they considered it their home. People using the service were kept as safe as possible from harm because staff understood what steps to take reduce and manage any identified risks to them. Staff understood how to protect people from abuse, including who to report any concerns to.

There were enough staff employed to meet people's needs. The provider had a safe staff recruitment process in place. This ensured that staff were properly checked and supported with induction and training. Overall medicines were being managed safely at the home, we did identify some improvements required in documentation. We found the premises to be clean although some improvement was needed to ensure the service remains consistently hygienic and clean. Staff used Personal Protection Equipment (PPE) effectively.

The service worked well with healthcare professionals and we saw prompt referrals had been made as required. Healthcare professional recommendations had been followed and this had benefited the people who lived at the home.

People, relatives, and staff all told us the home was well managed, and that the registered manager and provider were always visible and available to speak with. The culture was friendly and welcoming. The registered manager and provider were keen to receive feedback which would further improve the home and the care that people received. Quality monitoring systems had improved. Regular audits took place which helped to improve quality and safety.

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 (published 6 April 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

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

Why we inspected

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.

We carried out an unannounced inspection of this service on 10 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance arrangements in the home.

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 and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gresham care home on our website at

www.cqc.org.uk.

Follow up

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