Victoria Grand

Updated 24 August 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 undertaken by 2 inspectors.

Service and service type

Victoria Grand 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. Victoria Grand is a care home without 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 not a registered manager in post. A manger had been in post since November 2022 but had not yet submitted an application to register. They were not at the home during the inspection.

Notice of inspection

This inspection was unannounced.

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 7 people and a relative about their experience of the service. We spent time observing staff providing care to people and spoke with 6 staff, including 4 care staff, the chef, the maintenance person and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records relating to people’s care and the governance of the service.

Following the inspection we received information from the provider about incidents and accidents, a care plan and updated medicine records.

Updated 24 August 2023

About the service

Victoria Grand is a residential care home providing accommodation and personal care for up to 26 people. The service provides support to older people, people with dementia and younger adults. At the time of our inspection there were 13 people using the service. The care home accommodates people in an adapted building over 3 floors, there is a lift to connect the floors.

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

There were not always enough suitable staff to provide safe and effective care to meet people’s needs, including at night-time and for social support.

Risks to people were not always identified, assessed or managed effectively. Some people needed support with mental health needs and expressing feelings of distress or agitation. Staff did not have clear guidance about the level of risk and strategies to provide care safely. Medicines were not always managed safely because some protocols lacked detail to ensure staff had the information they needed when they administered medicines. Environmental risks and infection prevention and control risks were not always identified and managed. This meant there were increased risks of avoidable harm to people.

People were spending the majority of their time in their rooms, and some reported feeling isolated, bored and lonely. A person said, “I can spend hours and hours on my own.” Another person told us, “I am in my room a lot of the time, in fact most of the time.” Organised activities happened for a few hours on 2 afternoons a week. People said they saw no point in leaving their rooms because there was nothing to do. Staff told us they were too busy to spend time with people.

Care was task focused and care plans did not always support a personalised and holistic approach. Some people had mental health needs, but records did not reflect the support they needed. Staff told us they knew people well and this mitigated risks to some extent, but the lack of personalised records meant the provider could not be assured that people were receiving the care they needed and new or unfamiliar staff did not have all the information and guidance to support people.

Systems for assessing the quality and safety of the service were not all effective and robust. Audits had been undertaken on a regular basis but did not always identify shortfalls to drive improvements. A lack of effective leadership and management systems, including contingency plans, were not robust and this meant safe staffing levels were not maintained.

Staff understood their responsibilities for safeguarding people. People told us they felt safe living at the home, and they described kind and caring staff. 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.

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 31 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and the management of the home. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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, responsive 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. Following this inspection, the provider confirmed that they had taken action to make improvements.

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

Enforcement

We have identified breaches in relation to staffing, risk management, person-centred care which includes meeting people’s social needs, and leadership and management at this inspection.

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

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.