Archived: Gittisham Hill House

Updated 23 February 2016

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.

The inspection took place on the 5 and 7 January 2016 and was unannounced. An inspector and an expert by experience carried out this inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses a dementia care service.

Prior to the inspection we reviewed all information we held about the service. This included looking at the Provider Information Return (PIR), previous inspection reports and notifications the provider sent to us. A notification is information about important events which the service is required to tell us about by law.

We met most of the 36 people using the service, spoke with 16 of them and with three relatives and we looked at five peoples’ care records. Not everyone was able to verbally share with us their experiences of life at the home. This was because of their dementia/complex needs. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with ten staff, and looked at five staff records, including staff recruitment, training, supervision and appraisal records. We looked at the provider’s quality monitoring systems such as audits of records, health and safety audits, monthly reports to the provider and provider visit reports.

We sought feedback from health and social care professionals who regularly visited the home including GP’s, community nurses, and other therapists as well as commissioners and received a response from five of them.

Updated 23 February 2016

This unannounced inspection took place on 5 and 7 January 2016. We last inspected the service in October 2013 and found it was compliant with the standards inspected and there were no breaches of regulations.

Gittisham Hill House is registered to provide accommodation for a maximum of 39 people who require nursing and personal care. The home is situated near Honiton, Devon. The service specialises in the care of older people, most of whom are living with dementia. When we visited 36 people lived at the home, 19 of whom were receiving nursing care.

The service has a registered manager. 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.

People who used the service, relatives and health and social care professionals were impressed with the service and how people were treated. One relative said, “We are extremely satisfied with the care, she is looked after really well.” A health professional said, “A very nice place with nice people.”

People received effective care, based on best practice, from staff that had the knowledge and skills needed to carry out their role. Health and social care professionals consistently gave us positive feedback about the kindness, care and support provided for people. A visiting professional said, “The residents provided with a safe environment and their care is effective.”

People gave us very positive feedback about the food choices at the home. One person said, “We are well looked after with food.” People were supported with nutrition and hydration, although improvements were needed in adding up fluid records of what people at increased risk of dehydration had drunk each day.

The environment of care was adapted to meet the needs of people with physical disabilities and those living with dementia. The buildings have been significantly improved and refurbished with further improvements planned. The home had lots of areas of interest for people to sit, enjoy and spend time in. Some people who were restless were freely able to access all communal areas on the ground floor and go upstairs whenever they wished.

There was a calm and relaxed atmosphere in the home on both days we visited. The ethos of the service was that it was people’s home and staff respected people’s individual choices. Staff interacted in a kind and respectful way with people. For example, when a person became upset, staff noticed immediately and intervened to reassure them. Staff were friendly and cheerful and they knew each person well, what they liked to be called, their preferred routines; and their social and family history.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, relatives and health and social care professionals were consulted and involved in decision making about people in their 'best interest’.

People said they felt safe living at the home. Staff were aware of signs of abuse and knew how to report concerns, any concerns reported were investigated. A robust recruitment process was in place to make sure people were cared for by suitable staff. People knew how to raise concerns and were confident any concerns would be listened and responded to.

The service was well led. People, relatives and staff said the home was organised and well run. The culture of the home was open and friendly. Staff said they worked well as a team and felt supported and valued for their work. Senior staff acted as role models to support staff to achieve high standards of care.

The provider had a range of internal and external quality monitoring systems in place, which were well established. There was evidence of making continuous

improvements in response to people’s feedback, the findings of audits, and of learning lessons following accidents and incidents.