Gibraltar Road Nursing Home

Updated 29 March 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

This inspection was carried out by 1 inspector 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

Gibraltar Road Nursing 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. Gibraltar Road Nursing 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.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spent time in shared spaces with 4 people, we chatted to some people and observed the quality of care and the support they received. This helped us to understand the experiences of people who we were unable to communicate with effectively. We were asked to ensure staff were present when we entered shared spaces as some people may have become unsettled with new people being present. We spoke to 4 staff members in detail during the inspection, including the registered manager. We had conversations with 3 other staff on site at the time of inspection.

We reviewed a range of care records. This included care plans and daily records and medication administration records for 2 people. We spot check care records for other people. We also reviewed a variety of records relating to the management of the service, including risk assessment, quality assurance records, training data, policies an procedures. We received feedback from 3 relatives and spoke to 1 relative who was on site at the time of inspection.

Updated 29 March 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Gibraltar Road Nursing Home is a nursing care home providing personal and nursing care to 8 people at the time of the inspection. The service can support up to 10 people.

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

Right Support: 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. The provider acknowledged they were undertaking a thorough review of the service. The provider had a plan to improve the service’s systems and processes. The provider was working closely with local authority partners in the development of their service improvement plan.

Right Care: People received person-centred care. Staff respected people's rights and treated them with privacy and dignity. People had care plans and risk assessments in place, however, these were not always up to date. This meant people were at increased risk of not always receiving safe care and treatment. The registered manager was open and transparent about work being done to update care plans and risk assessments. The registered manager had a plan to ensure care plans and risk assessments were routinely reviewed and kept up to date.

Right Culture: The culture of the service supported people and staff in an inclusive way; enabling people to live their day-to-day lives as they chose to. Staff told us that the culture of the service had greatly improved as a new team had been formed. However, quality assurance systems to assess and monitor the service were not always being routinely used and CQC was not always being sent notifications as required. Notifications are communications informing CQC about events the provider needs to tell us about. This meant the provider did not have enough of an oversight of the service to ensure it was being managed safely and quality maintained. Therefore, we could not be assured people always receive high quality care. The registered manager had a plan to ensure the necessary quality assurance systems were in place.

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

Rating at last inspection

The last rating for this service was good (published 10 September 2019).

Why we inspected

We received concerns in relation to governance, care planning, risk management, health action plans, mental capacity assessments and best interest decisions, staffing and medicines management. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gibraltar Road Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.