We carried out a review of the data available to us about OSJCT Grevill House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about OSJCT Grevill House, you can give feedback on this service.
OSJCT Grevill House is a residential care home providing personal and nursing care to 68 people. At the time of our inspection there were 44 people using the service. The service provides support to people who require long and short-term care, some of whom live with dementia.
On the same site is the Ashley unit. This is a short-stay assessment and enablement unit. Both buildings are purpose built and have been adapted to meet people’s needs. People in each building have access to outside spaces to enjoy in good weather.
People’s experience of using this service and what we found
People’s safety was supported and maintained. Risks related to people’s health were assessed, and action taken to mitigate and reduce risks. Environmental safety checks were completed and risks identified and mitigated.
People told us they felt safe with the staff who supported them. Appropriate recruitment checks were completed before staff started work. Staffing numbers, and skills had been reviewed to ensure there were enough staff to meet people’s needs. Successful ongoing recruitment of staff was supporting the growth of a permanent staff team and less need for agency staff. Staff were trained in safe ways of working and on how to recognise and report safeguarding concerns. People received the support they required to take their prescribed medicines.
The service was well managed. A new manager had recently started work, along with recent additions to the senior staff team. People who used the service, their relatives and staff spoke positively about these changes. A team approach to work was being promoted and new and longer standing staff told us they felt well supported. The manager was keen to meet people and their relatives; to hear their views on the service and to use this feedback to make further improvements to the services provided.
The manager and provider had systems and processes in place to monitor the performance of the service along with staff performance and practice. Staff told us they felt positive about the changes being made by the manager.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
People had a choice about their living environment and were able to personalise their rooms.
People could access specialist health and social care support in the community.
Right Care:
People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood and responded to their individual needs.
Right Culture:
Managers and senior staff modelled good practice and led by example.
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 19 March 2020).
Why we inspected
We received concerns in relation to staffing, the quality of care provided and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for OSJCT Grevill House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
¿ The service had developed a dedicated building with en-suite rooms to care safely for people who were admitted to the service with COVID-19. The building had its own access and was able to be separated from Grevill House. Measures were in place to keep people safe and well cared for, and to reduce the risk of infection spreading outside of the building. For example, staff only worked in Ashley Intermediate Unit and did not work in the main building (Grevill House).
¿ Systems were in place to reduce the risk of cross infection throughout the service. Ashley Intermediate Unit had its own laundry facilities. There were set processes in place to clean and sanitise used eating utensils to reduce the risk of the virus being contracted outside of the unit.
¿ Enhanced cleaning schedules including regular cleaning of frequently touched surfaces such as handrails and door handles were in place. This reduced the risk of cross infection. Additional equipment had been purchased to enhance infection control measures. For example, handwashing and PPE stations, decontamination devices which neutralized rooms and soft furnishings. The provider and registered manager also purchased items which enabled them to monitor cleanliness of the service as well as staff hand hygiene.
¿ Ashley Intermediate Unit had a designated staff team. This reduced the risk of infection spread. Staff had received additional training in infection prevention and control and end of life care. Staffing numbers had been decided on for the unit and clear leadership arrangements were in place. Management of Grevill House were also available to provide virtual support.
¿ Staff employed by the service did not work in any other care setting. This meant the risk of cross infection was reduced.
¿ The provider and registered manager were proactive in keeping up to date with best practice guidance and had been involved in pilot schemes to assist with advancement in technology, infection control and COVID-19 testing.
¿ The providers infection prevention and control policy was up to date. People and staff had risk assessments in place to identify their individual risks associated with COVID-19. This meant protective measures could be put in place to keep people and staff safe.
We were assured that this service met good infection prevention and control guidelines as a designated care setting.
OSJCT Grevill House is a residential care home which has a residential reablement and rehabilitation service on the same site called Ashley Intermediate Care Centre. The care home is registered to accommodate 65 people in two separate buildings on the same site. At the time of the inspection the main care home was supporting 43 people. Ashley Intermediate Care Centre provides a service to 15 people and was full at the time of the inspection. Both services predominantly provide care and support to people aged 65 years and over.
People’s experience of using this service and what we found
People told us they felt safe. People were protected from potential abuse and discrimination. People told us they received their medicines as prescribed and were given the support they needed to take their medicines. Medicines were managed safely and were available for people when they needed them. Risks to people were assessed and action taken to reduce these. The home was clean, and measures were in place to reduce the spread of potential infection.
There were enough staff with the right skills and experience to meet people’s needs. Staff were recruited safely, and a successful staff recruitment campaign had already brought more stability to the staffing team by reducing the usage of agency staff.
People told us they received the support they needed. Staff received the training and support they needed to be able to meet people’s diverse needs. People could access specialist and community based healthcare professionals as required.
People told us they had a choice in what they ate and drank and that they enjoyed mealtimes. People’s specific nutritional and dietary needs were managed well. Specialised equipment, including some environmental adaptions were seen in both services to support people’s individual needs.
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. The principles of the Mental Capacity Act were followed, protecting those who lacked the capacity to make independent decisions.
People told us staff were caring, helpful and respectful towards them. People’s dignity and privacy was upheld. People were treated equally and as individuals. Staff knew people well; their likes and dislikes as well as their preferences when it came to their care. People were involved in planning their care, and their relatives and representatives were included in this process when appropriate.
Those who mattered to people, relatives, friends, representatives and people’s pets were made welcome when they visited. People were supported to regain independence and to live as independently as possible.
Care plans recorded people’s needs and gave staff guidance on how to meet these. This included information about people’s end of life wishes. Care records were reviewed regularly and kept up to date so staff and visiting professionals had access to relevant information about people’s needs, care and treatment.
People enjoyed the social activities provided. People’s involvement in these was encouraged and supported by staff who recognised the importance of meaningful activities in people’s lives. Staff did everything they could to reduce risks associated with loneliness and self-isolation.
There were arrangements in place for people and visitors to raise a complaint. Managers worked hard to remain visible and approachable so that ‘niggles’ or concerns could be discussed and resolved early on.
The registered manager and senior staff provided strong and supportive leadership. Staff told us communication had improved under the present registered manager and they told us they felt valued. Feedback was sought from people, their representatives and staff and used to improve the overall service.
There were arrangements in place to monitor the quality of the services provided and to make improvements where needed. Staff worked collaboratively with individuals and groups from the wider community to improve people’s quality of life.
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 14 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection, the service was rated Good. This inspection took place on 16 and 19 June 2017 and was unannounced. At this inspection we found the service remained Good.
People and their relatives were positive about the support and care they received. They praised the staff and told us they were treated with warmth, dignity and respect at all times. Staff understood people’s needs and responded effectively if people’s health and emotional wellbeing changed. Records showed that health care professionals had been contacted when staff needed extra support or advice.
People’s risks had been assessed and were managed in line with their care plans and health care professional recommendations. However, the care files of people who stayed on the Ashley Intermediate Care Centre did not always effectively reflect their support needs or re-enablement goals. Whilst we found staff we spoke with were knowledgeable about people’s care needs and re-enablement goals their care plan did not provide staff with all the information they would need to know how to support people if they were to solely rely on their care plans. At the time of our inspection the provider was taking action to further improve people’s care plans.
People were encouraged to agree to the care and support being provided. People’s mental capacity had been assessed before staff made best interest decisions on their behalf. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff felt trained and supported to carry out their role. Their professional development was being monitored and they were encouraged to undertake additional qualifications in health and social care. People were protected from harm and abuse as staff had been trained in safeguarding people and were knowledgeable about reporting any concerns. There were sufficient staff on duty to ensure people’s physical, emotional and social needs were being met in a timely manner. Safe recruitment practices were being used which meant that people were supported by staff of good character.
Systems were in place to ensure people received their medicines as prescribed. Where medicine errors occurred, the registered manager carried out a full investigation, reflected on their findings and carried out actions to reduce the risk of future errors.
The registered manager was accountable for both Grevill House and Ashley Intermediate Care Centre. Monitoring systems were in place to ensure the services were operating effectively and safely. Internal and external audits were carried out to continually monitor the overall services provided. Shortfalls identified in the monitoring of the services were acted on however more time was needed to ensure concerns relating to people’s care plans would always be identified and rectified promptly. The registered manager was planning to review the auditing and monitoring of the Ashley Intermediate Care Centre to ensure people received safe and effective care.
Further information is in the detailed findings below.
This inspection took place on 5 May 2015 and was unannounced. The Orders of Saint John Care Trust site accommodates two homes which were both inspected during this inspection. Grevill House provides accommodation for 50 people who require nursing and personal care over two floors. Adjacent to Grevill House is the Ashley Intermediate Care Centre which offers intensive support and care for 15 people who require rehabilitation following a hospital stay, before they return home. Both services stand in well maintained gardens.
A registered manager was in place as required by their conditions of registration. 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. The registered manager was not available during our inspection, so we spoke with the head nurse and two of the provider’s representatives. We spoke with the registered manager by telephone after the inspection.
People were protected against abuse because staff knew how to report any concerns of abuse to the relevant safeguarding authorities. Risks for individual people had been assessed. Staff were given guidance on how to best support people when they were at risk of harm. Staff had been trained to support and protect the people they cared for. Policies to protect people were in place to give staff guidance. Staff managed people’s medicines well. They were ordered, stored and administered effectively. People who stayed on the intermediate care unit were supported to become independent in managing their own medicines.
People told us they felt there were enough staff to meet their needs. Thorough recruitment checks and an induction programme were carried out with new staff before they provided care to people. Training plans and systems were in place to ensure people were cared for by staff who received regular training and support from their line manager. Staff told us they were supported.
People’s individual needs were assessed, planned and reviewed. Care records gave staff guidance on how people should be supported and on how their risks should be managed. However, people’s social and mental health needs and goals were not always recorded for those people who stayed on the intermediate care unit. People received additional care and treatment from other health care services when needed. Staff encouraged people to have a well-balanced and nutritional diet. A new chef was responding to people’s views and feedback about the meals.
Group and individual activities were provided in Grevill House however, there were limited opportunities for social interactions in the intermediate care centre. People and their relatives spoke highly of the staff and the registered manager. Relatives told us that any day to day concerns, which they had raised, were always dealt with immediately. Complaints were managed effectively and actions were put in place to prevent the concern reoccurring.
Both services were well led. Monitoring systems were in place to ensure the services were operating effectively and safely. Internal and external audits were carried out to continually monitor the overall services provided.
People told us how they received enough help to meet their needs. However we did find examples of where the service was not monitoring people's weight as planned. We found the environment in both the care home and the intermediate care unit had been well maintained. We looked at staff recruitment and found that required checks had been made before staff started work in the service. Although we did not ask people specific questions about staff recruitment, we did hear positive comments about the staff such as 'brilliant' and 'civil and gentle'.
We found that the service had an effective complaints system and complaints were recorded and responded to appropriately.
We found some shortfalls with records relating to people's care and with staff recruitment.
who use the service or their representatives.
People we spoke to made positive comments about the staff, one person described them as 'very good indeed.' and another said that they were "very pleased with the staff'. Staff in the Intermediate care centre staff were described as 'all very kind ".
They also told us how staff respected their privacy and how the home was kept clean.