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Grosvenor Lodge Requires improvement

Reports


Inspection carried out on 13 June 2019

During a routine inspection

About the service

Grosvenor Lodge is a residential care home providing personal care for up to 31 older people some of whom were living with dementia. There were 30 people living at the service during the inspection.

Grosvenor Lodge accommodates 31 people in one adapted building. There were three shared lounges, a dining room and accessible garden.

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

Risks to people were not always appropriately recognised and assessed. Risks around people’s health diagnoses, behaviour that may challenge and specific healthcare aids had not always been recognised and planned for. When people’s behaviour could challenge, this was not always recorded and monitored appropriately. Safeguarding was not always reported appropriately when people displayed behaviour that challenged which affected other people.

People were not always supported to have maximum choice and control of their lives and staff did not support always them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

The quality assurance framework was not effective and had not supported the provider to identify and address the areas needing improvement. There was no guidance in place for medicines which were prescribed ‘as required’ (PRN). Staff were supported when they began administering medicines, and their competency to do this was checked, but this was not recorded.

People were treated with kindness, dignity and respect and encouraged to express their views and be involved in their care. One person told us, “It’s my favourite place to come to.” Another person’s relative said, “I'm happy that she is safe and well looked after.”

People’s needs were assessed before they moved into the home. Care plans included people’s life histories, hobbies and interests. When appropriate, people’s preferences for the end of their lives had been discussed with them and their relatives.

There were enough staff available to meet people’s needs. Staff were recruited using safe recruitment methods and supported with induction, training and regular supervision. Staff told us they felt supported by the management team.

People were supported to eat and drink, staff knew about anyone with specialist needs around food. People were supported to access health care support as needed. Staff worked in partnership with other agencies and professionals to support people.

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 (9 March 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches of regulation in relation to the governance of the service. The provider failed to ensure that they had assessed, monitored and mitigated the risks relating to health, safety and welfare of people and others. The provider had not ensured that an accurate, complete and contemporaneous record in respect to each person had been kept.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 21 December 2015

During a routine inspection

This inspection took place on the 21 December 2015. Grosvenor Lodge was last inspected on 4 June 2014 and no concerns were identified. Grosvenor Lodge is located in Hove. It provides accommodation with personal care and support for up to 31 older people, some of whom were living with varying stages of dementia, along with healthcare needs such as diabetes and sensory impairment. Accommodation was arranged over three floors. On the day of our inspection, there were 28 people living at the service.

There was a registered manager in post. 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 were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “I feel safe living here”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including diabetes management and the care of people with dementia. Staff had received both one-to-one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place. One member of staff told us, “If the manager thinks it will help us, the training will be there”.

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. One person told us, “They give us two options, but if we don’t like either of those, we can ask for something else”. Special dietary requirements were met, and people’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.

People chose how to spend their day and they took part in activities in the service and the community. People told us they enjoyed the activities, which included singing, exercises, films, arts and crafts and themed events, such as reminiscence sessions. One person told us, “They do activities. We’ve been making things like decorations. They do sing songs and we’ve been singing Christmas carols. I’ve made friends here”. People were also encouraged to stay in touch with their families and receive visitors.

People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. One person told us, “The staff are very kind”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible.

People were encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed.

Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns. The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.

Inspection carried out on 27 September 2013

During a routine inspection

People living at the home we spoke with told us they were happy with the care they received and told us that they liked the staff team.

One service user told us “I’m very happy to be here, the care is good.” Another service user said “I get on with the staff,” and, “I think they’re pretty good.” A third service user we spoke with said “I love it here.”

A family member told us “Staff are friendly and helpful. The care is personalised and it is ‘caring’ care. The manager is good and there is a real relationship between the staff and my relative.”

A visiting local authority care manager told us that the service user they were reviewing six weeks after arriving at the home had “really settled in well,” and that the home had a “stable core team and feels like a family.”

Inspection carried out on 6 July 2012

During a routine inspection

During our visit we spoke with people who lived at the service, relatives and staff members.

We also took information from other sources to help us understand the views of people living at the home to include surveys.

The people we spoke with told us they were happy with the care they received and with the staff team.

Staff we spoke with knew the people living at the home well and had a good understanding of their support needs.

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