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Archived: The Grove Care Home Requires improvement

Reports


Inspection carried out on 19 February and 2 March 2015

During a routine inspection

This inspection took place on 19 February 2015 and was unannounced. We continued the inspection on 2 March 2015 to look at documents relating to assessment and monitoring of service provision. This visit was arranged with the nominated individual at their earliest availability following the first visit. When we last inspected The Grove Care Home in April 2014 we found the home was failing to meet the standards required in all of the regulations we assessed. We told the provider that improvements must be made.

When we inspected the service on 8 April 2014 we found the registered provider was not meeting the regulations relating to respecting and involving people who use services, cleanliness and infection control, staffing, assessing and monitoring the quality of service provision and records. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

The Grove Care Home is registered to provide residential care for up to 28 older people. Bedrooms are situated on both the ground and first floor with communal lounges and dining room on the ground floor. There were 15 people living at the home at the time of our inspection.

A new manager has been in position since October 2014. This person has registered manager status in another of the provider’s services and is currently applying to the Care Quality Commission to transfer this status to The Grove. 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 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that the new manager had taken sufficient action to meet with most of the compliance actions set as a result of our inspection in April 2014. Staffing arrangements were still in need of improvement.

People told us they felt safe and staff knew how to maintain people’s safety although some had not had the required training. People told us they sometimes had to wait for support as staff were very busy and although attentive, were not always available to them.

The home was generally clean although adequate hand washing facilities were not always in place.

Staff training was in need of updating particularly in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). We saw that training had been arranged in this and other areas. Systems for supporting staff were in place and although some slippage had occurred, the new manager was addressing this.

Staff treated people with kindness and respect. People who lived at the home and their relatives told us the staff were very caring.

Staff respected people’s right to make choices and knew how to support people in this. People received a nutritious diet and found the food enjoyable.

Care planning had improved since our last inspection and plans were in place for further development.

Activities were provided but this was not at a level which would meet the needs of all the people living at the home.

Processes were in place for auditing the quality of service provision. The new manager was in the process of bringing these up to date.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 8 April 2014

During a routine inspection

This visit was carried out by one inspector who spoke to people using the service, a relative, and staff. The inspector also through observation and looking at records used the information they were given to answer the five questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. Safeguarding procedures were in place and staff understood how to safeguard the people they supported.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and these had been used effectively.

There were not always sufficient numbers of staff with the right qualifications, skills and experience available. This meant that people could be put at risk.

People's care records did not always accurately reflect their current needs.

The home was not clean and people could be put at risk through poor infection control management.

We have said improvements are needed.

Is the service effective?

People told us they were looked after and that staff were kind and respectful in their approach. Health care professionals such as GPs and district nurses were involved, as needed, in people's care. However, people were not involved in their needs assessments or in the writing their plans of care.

Is the service caring?

People were supported by kind and attentive staff. Staff we spoke with knew about people�s care and support needs and their individual preferences.

People�s preferences, interests and needs had been recorded and care and support had been provided in accordance with people�s wishes.

Is the service responsive?

People told us that staff responded to their needs and were well looked after. We saw staff supporting people in an encouraging and caring manner.

Is the service well-led?

There had been a number of changes within the home. These included ceasing to provide nursing care which had impacted heavily on the staffing structure and staff roles and responsibilities within the home. There had also been a number of changes at management and senior management level.

Procedures for auditing and responding to identified problems were not robust. Infection control procedures were not being followed and the home was not clean. Changes to staffing levels had not been made on a consistent basis despite issues being identified.

Care records were not kept securely and confidential information was easily accessible.

Some care records were not accurate or up to date.

We have said improvements are needed.

Inspection carried out on 13 April 2013

During a routine inspection

We visited The Grove Care Home on a Saturday and there were 21 people using the service. We spoke with five people who used the service, seven visitors, six staff and the manager. We reviewed three staff files and three care records.

People looked well cared for and were seen to have good relationships with the staff. People who used the service told us they were happy living at the home and they were well looked after. We observed people were treated with respect and dignity. People told us the laundry service was good.

The home was undergoing a refurbishment programme and we saw that improvements had been made to the environment in some areas. People told use they liked the lounge and dining areas as they were �Bright and cheerful�.

Care records were person-centred and reviewed monthly with risk assessments used to develop guidelines for staff to follow to reduce an identified risk.

We saw arrangements are in place for the management and administration of medicines.

Staffing levels had increased since our previous inspection and systems were in place to recruit more permanent nurses.

We saw that staff had received supervision and appraisals. Training needs had been identified and plans were in place for mandatory and developmental training for staff.

We saw there were systems in place to monitor and audit the quality of service people received.

Inspection carried out on 20 June 2012

During a routine inspection

People say they enjoy living in the home. One person said � Moving into the home was the best thing they had ever done�. Another said the �staff are very good and nothing is to much trouble�� A few people said they are looking forward to seeing the hairdresser later in the day. Another person said they �have been poorly, but the Nurses are very good and look after them�. Some people who we could not communicate with were observed to be relaxed and comfortable. A visiting relative said that they have been visiting the home for a number of years and have always been happy with the care provided for their relative.

People say they like living in the home. One person said �If they have any concerns they can tell someone and �its sorted�. One person said they �feel very safe and well cared for�. People we could not communicate with appeared to be happy, very relaxed and comfortable. One visiting relative said they are very happy with the care and support provided.

One person said their �bedroom is very good� and they �have everything they need�. Another says the home is �second to none� and �always kept clean and tidy�. One person said �moving into the home is the best thing they have ever done�. Another said they �have tried other homes, but this was the best� People who we could not communicate with appeared to be comfortable relaxing in a homely, well maintained and safe environment. One visiting relative says they have been coming to the home for a number of yeas and never had any issues.

People say they like the people caring for them. One person said the staff are great and they have been poorly but the nurses made sure he was alright.

People say they like the people caring for them. Some people we could not communicate with appeared to be happy and positive relationships were observed being fostered between those living in the home and those caring for them. The visiting hairdresser said the staff are very good and always helpful and welcoming. One visiting relative said the staff are very good and very caring.

One visiting relative said they have been coming to the home for a number of years and all the staff are very helpful and very caring. People living in the home say they like the people caring for them. People we could not communicate with appeared to be relaxed and comfortable with those supporting them.

People living in the home say they like living there and the people caring for them. People visiting the home say they like the staff and feel that peoples care needs are met.

Reports under our old system of regulation (including those from before CQC was created)