Background to this inspection
Updated
17 February 2021
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 Care Act 2014.
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
The inspection was completed by four inspectors on 27 October 2020. One inspector was assigned to Kennett House, Medway House and Chelmer House respectively. One inspector reviewed the service’s infection control and prevention measures in three out of four houses.
Service and service type
Ghyll Grove Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the Local Authority prior to the site visit and made telephone calls to people’s relatives on 14, 15 and 16 October 2020. A variety of records relating to the management of the service were reviewed. We used all of this information to plan and inform our inspection.
During the inspection
We spoke with three people who used the service about their experience of the care provided. We spoke with the interim manager, area director, area quality director, qualified nurses, senior care staff, care staff and housekeeping staff. We also spoke with one healthcare professional. We reviewed a range of records and this included people’s care records. We looked at two staff files in relation to their conduct.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at Medication Administration Records [MAR] for 12 people using the service, staff supervision records for four members of staff and quality assurance and governance records.
Updated
17 February 2021
About the service
Ghyll Grove Care Home is a residential care home providing personal and nursing care for up to 169 older people. Some people have dementia related needs and some people require palliative and end of life care. The service consists of four houses: Kennett House, Medway House, Chelmer House and Thames House. At the time of our inspection there were 79 people living at the service.
People’s experience of using this service and what we found
Effective arrangements were not in place to mitigate risks for people using the service and staff employed at the service. Not all appropriate measures were in place or being followed to prevent and control the spread of infections. Effective arrangements were not in place to protect and prevent people who used the service from abuse or to properly investigate where concerns were raised.
The leadership, management and governance arrangements did not provide assurance the service was well-led. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. Governance arrangements, including performance management, roles and responsibilities required improvement. Lessons were not consistently learned to improve the service for people using the service.
People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
There were enough staff available to meet people’s needs. Suitable arrangements were in place to ensure the proper and safe use of medicines.
At this inspection we found improvements had been made relating to staffing levels and the deployment of staff; and the provider was no longer in breach of Regulation 18 of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. However, not enough improvement had been made relating to governance and the provider was still in breach of Regulation 17 of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014.
Rating at last inspection (and update) The last rating for the service was Requires Improvement, [published January 2020]. This service remains rated Requires Improvement. This service has been rated Requires Improvement for the last three consecutive inspections.
Why we inspected
This was a focused inspection based on the previous rating and prompted in part due to concerns raised by the Local Authority in July 2020. A decision was made for us to inspect and examine the risks identified by the Local Authority. A focused inspection was carried out to review the key questions of ‘Safe’ and ‘Well-Led’ only.
We also 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.
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 Ghyll Grove Care Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.