Archived: Gallions View Care Home

Updated 13 May 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 28 and 29 July and 2 August 2016 and was undertaken by two adult social care inspectors, one pharmacy inspector, one specialist advisor and one 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.

Before the inspection we looked at the information we held about the service including information from notifications they had sent us. We also asked the local authority commissioning the service and the safeguarding team for their views of the service.

We spoke with 13 people who used the service, four relatives, 13 members of staff, the acting manager, the clinical lead and two members of the provider’s recovery team who support and oversee improvements. We reviewed records, including the care records of nine people who used the service and 14 staff members' recruitment files and training records. We also looked at records related to the management of the service such quality audits, accident and incident records and policies and procedures.

Updated 13 May 2020

This inspection took place on 28 and 29 July and 2 August 2016 and was unannounced. At the last comprehensive inspection of this service on 25 and 26 November 2015 we found breaches in legal requirements in relation to safe care and treatment and monitoring the quality and safety of the service. We took enforcement action and imposed a condition on the provider’s registration so that we could monitor the action being taken by the provider to address the concerns we found. We required the provider to submit information to us on a monthly basis and this came in to effect in February 2016.

We received further concerns about the service and carried out a focused inspection on 7 March 2016. At this focused inspection we found continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014 in relation to safe care and treatment and monitoring the quality and safety of the service. We placed a condition on the service’s registration that no new admissions could be made to the home.

Gallion’s View Nursing Home provides personal care and nursing care to older people and those living with dementia. The service can accommodate up to 120 people in four separate buildings. At the time of this inspection 82 people were using the service. The day before our inspection one of the units was temporarily closed and people who used the service were moved to two out of the three remaining units.

The service had a registered manager who has been in post since 2011. 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. However, at the time of our inspection the registered manager had been on extended leave since June 2016. The deputy manager was managing the service as acting manager and was being supported by the provider’s recovery team who oversee and support improvement

At this inspection we found continued breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014.

People’s safety had been compromised in that medicines were not always managed safely. Risks to people had been identified but care plans did not always record guidance in order for staff to enable staff to manage these risks safely accident and incident logs were not always completed. Audits had either not been carried out or were not always effective in identifying shortfalls in the safety or quality of the service

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded

Mental capacity assessments and ‘best interests’ meetings were not always carried out in with the MCA when there were concerns regarding a person’s ability to make a decision. Care plan audits did not always identify the risks recorded by healthcare professionals and people were not always referred back to healthcare professionals for follow ups or reviews. Care plans did not always record guidance for staff on how to support and meet people’s needs. Complaints were not logged, investigated, monitored or maintained in line with the service’s complaints policy. The number of staff deployed across the three units, were not always enough to meet the needs of people who used the service. Staff did not feel consulted or involved in the running of the service and told us communication with management was poor. You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.

We saw at times staff interaction with people was limited unless they were task orientated. We found activities offered at the home required improvement to meet people’s needs for stimulation and social interaction.

Safeguarding adult's procedures were robust and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.

Staff received supervision, appraisals and training appropriate to their needs and the needs of people they supported to enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.

Staff respected people’s privacy and dignity. Staff knew people well and remembered things that were important to them so that they received person-centred care. People's nutritional needs and preferences were met.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to consider the process of preventing the provider from operating this service. This may lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement and there is still a rating of inadequate for any key question or overall, we may take action to prevent the provider from operating this service. This may lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.