The Grove

The Grove is a care home that provides a short-break service for up to eight to people with learning and physical disabilities. Two rooms at the service that can accommodate people with physical disabilities who use wheelchairs. At the time of the inspection 61 people used the service at least once during the year. People’s visits range from a couple of days to a week-long stay. The home can also provide a crisis service for people who may need to stay somewhere for a little longer.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People told us they enjoyed their visits to the service and felt staff ensured they had an enjoyable holiday. They described how staff knew them well, provided them with all the support they needed and how this was the best short-break service they had used.

The registered manager and staff consistently demonstrated they valued and respected the people who used the service. The staff were passionate about supporting people to enjoy their stay and have a holiday experience. The staff team consistently considered how to enhance people’s lives whilst they stayed at the home and offered a wide range of activities and outings for people to go on.

Staff were committed to delivering a service which was person-centred. Some people used Makaton and other sign language, but communication plans did not contain information about what signs meant. The registered manager stated they would ask families to help staff produce dictionaries of what signs meant for the person.

The registered manager planned bookings in advance and co-ordinated them to reflect people were compatible and there were enough staff on duty. The staffing levels were increased or decreased in line with the number of people at the service and their needs.

Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately and lessons were learnt, which helped to keep people safe. People's support needs were thoroughly assessed and reviewed prior to each visit to ensure the information the home held remained accurate.

Staff actively promoted equality and diversity within the home. Staff respected people’s cultural and religious beliefs and practices. 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.

Staff supported people to manage their healthcare needs and promoted their wellbeing. When necessary, external professionals were involved in individuals care. The staff supported people to eat varied, appetizing meals. Medicine was administered in a safe manner.

Thorough checks were completed prior to staff being employed to work at the service. Staff had received appropriate training and supervision. The provider had enabled staff to access a varied and extensive range of condition specific training. The staff had found the training they received assisted them to significantly improve people’s quality of life but felt they would benefit from more practical training around working with people who displayed distress behaviours and sign language. The regional manager immediately put measures in place to support staff access this training.

People’s voices were of paramount importance in the service. The registered manager understood how to investigate and resolve complaints.

The service was well run. Systems were in place which effectively monitored how the service operated and ensured staff delivered appropriate care and treatment.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection

Good (report published 8 August 2017).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The Grove is an eight bed care resource that provides a short break service to people with learning and physical disabilities. At the time of the inspection 62 people used the service and at least once per year their visits would range from a couple of days to a week long stay.

The registered manager had retired in April 2017. 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. We found that a new manager was in post who was completing the process to become the registered manager.

We observed staff practices and spoke with relatives as the majority of people who were using the service at the time of our inspection had limited ability to verbally communicate their views about the support they received. However, some people were able to share their broad ideas about how effective they thought the service was for them.

People and relatives told us they were happy using this short-break service and found that, despite people only using the service a couple of times a year, staff remembered what they liked and needed.

We found, as had the manager and provider, that work had been needed to ensure staff training, supervision, care records and quality assurance processes were completed and up to date. We saw that the manager had developed a comprehensive action plan, which detailed all that needed to be done and much of this work had already been completed.

People told us they felt safe and protected in the service. They said they were well looked after by the staff. Any risks they might encounter in their daily lives were assessed by the staff and actions taken to minimise any harm to them. Staff had been trained in safeguarding issues and knew how to recognise and report any abuse.

People received their medicines in a safe and timely way.

There were enough staff to meet people’s needs and support them to enjoy their stay. New staff were carefully checked to make sure they were suitable to work with vulnerable people.

There was an established and experienced staff team who had a good knowledge of people’s needs and preferences.

We heard that the cook provided a wide range of nutritious meals and saw people enjoying their evening meal. Staff provided support in a sensitive manner.

Staff had received training about the application of the Mental Capacity Act 2005 (MCA) and ‘Best Interest’ decisions. The manager was in the process of developing bespoke training around what the expectations were when applying the MCA in short-break services.

Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. The provider told us they were developing new care records for the company and we discussed what type of records were needed in a short-break service.

Activities and outings were provided according to people’s preferences.

People felt involved in their care and support. They said they were encouraged to make choices about their lives and to be as independent as possible. People told us they had no complaints about their care, but would feel able to share any concerns they had with the staff.

People had the opportunity to give their views about the service. People and their family members were regularly consulted and their views were used to improve the service.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

Risk assessments were in place. Most risks to people who used the service, their relatives and staff were regularly assessed and appropriate steps were usually taken to minimise such risks. Appropriate action had not been taken however to minimise the risk of fire. People were supported and encouraged to maintain their independence and this was balanced with the risk to the person. Systems were in place for checking safety equipment and systems such as fire alarms.

Audits were carried out to look at accidents and incidents and the necessary action was taken to keep people safe. Information was available to show that the service worked with other agencies to help ensure people's health needs were met and to prevent admissions to hospital wherever possible.

Staffing levels were in place to ensure all the needs of the people who lived at the service were met in a timely way and to ensure their safety.

Is the service effective?

Some people could tell us they were happy with the care and support provided by staff. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well as individuals.

Staff had received regular training to meet the needs of the people who used the service.

An effective regular environmental audit was not in place to ensure the premises were safe and well maintained for the safety and comfort of people who used the service.

Is the service caring?

People were supported by kind and attentive staff, who showed patience and gave encouragement when supporting people.

Is the service responsive?

People's needs had been carefully assessed before they started to use the service. Records confirmed people's preferences, interests and needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities that were important to them.

Is the service well-led?

The home had a registered manager in post. There was an ethos of involvement and it was apparent the manager was passionate about ensuring people who could not communicate and make their needs known verbally should be involved and engaged in daily living, to improve their experiences. Staff we spoke with were enthusiastic about their role working with people and they were knowledgeable about the support needs of people. Staff told us they were clear about their roles and responsibilities. They said they felt supported by the manager and advice and support was available from the manager. Staff had a good understanding of the ethos of the service. A range of quality assurance processes were in place within the service. An external quality assurance system needed to be introduced by the provider to monitor the quality of care provided by the service.

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One person said," Staff are very kind." Another person said; "I am asked what I want to do."

Other comments included; "Staff are excellent; and easy to talk to." " We go out to the pub or for meals."

People said the food was excellent and there was plenty to eat.

Staff we spoke with said they enjoyed working at the service and they had opportunities for personal development and career progression.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes and legal requirements.

The premises were refurbished for the comfort of people who used the service.

There were enough qualified, skilled and experienced staff to meet people's needs.

We saw the provider had systems in place to gather feedback from people, who used the service, and to regularly assess and monitor the quality of service people received.