Archived: Grosvenor Park Care Home

We inspected Grosvenor Park Nursing and Residential Home on the 28 February 2017. This was an unannounced inspection.

Grosvenor Park Nursing and Residential Home is a care home with nursing located in Bexhill on Sea owned by BUPA Care Homes Limited. It is registered to support a maximum of 57 people. The service provides personal care and support to people with nursing needs and increasing physical frailty, such as Parkinson’s disease, multiple sclerosis and strokes. There is also a rehabilitation service provided for up to 10 people who were non-weight bearing following an operation with specialised input from a physiotherapist and occupational therapist. We were told that some people were also now living with a mild dementia type illness. There were 54 people living at Grosvenor Park Nursing and Residential Home during our inspection, nine of which were there for rehabilitation

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 and shares the legal responsibility for meeting the requirements of the law along with the provider.

At a comprehensive inspection in May 2015 we found the 'responsive' question required improvement. There was a breach of regulation 16 because the provider had not ensured that there was an accessible system for identifying, receiving, recording, handling and responding to complaints by people in relation to the service delivery. We received an action plan from the provider that told us how they were to meet the breach of regulation by May 2016.

This unannounced focused inspection on the 28 February 2017 was to look specifically at the ‘responsive’ question and we found that that they had now met the breach of regulation previously found.

This inspection demonstrated that peoples’ concerns and complaints were appropriately recorded, investigated and responded to. People told us that they felt listened to. Resident and staff meeting minutes were available told us that peoples and staff comments were taken seriously and discussed at these events.

Care plans and risk assessments reflected people’s assessed level of care needs and care delivery was based on people's preferences. This included up to date information of falls, skin damage, nutritional risks including swallowing problems and risk of choking and moving and handling. Staff responded to peoples’ changing needs. For example, cushions were in place for those that were susceptible to skin damage and pressure ulcers. The care plans also highlighted health risks such as diabetes and Parkinson’s. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's changing needs were met in a responsive way.

A range of activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activity sessions were provided throughout the whole day, five days a week and were in line with people's preferences and interests.

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, our observations made during the inspection and the records we looked at.

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

Is the service safe?

Systems were in place to make sure that all staff learnt from events such as accidents and incidents, complaints, concerns and adverse inspection findings. One area seen to be effective in reducing risk to people was a daily call bell audit that identified delays in answering call bells. Any delay in answering a call bell was immediately brought to the manager's attention and investigated immediately. We saw that trends, such as delays at weekends had been identified and action plans to address this were in place. For example, extra staff and continued monitoring of staff delegation within the home. This helped reduce risks to people and enabled the service to improve.

We looked at staffing levels and saw that staffing levels had been affected by staff sickness. We were told by the manager that the organisation were looking at a new staffing proposal to cover absences' safely with their own staff if possible. We did identify staff shortage on the day of our inspection and saw that a staff member had been sent home unwell. An agency nurse had been requested, until then the manager was supporting staff on the floor.

CQC monitors the operation of the Deprivation of Liberty safeguards (DoLS) which apply to care homes. This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted at Grosvenor Park, we found that suitable policies and procedures were in place. We spoke with staff that informed us of recent training in safeguarding and DoLS procedures that had clarified the procedures and policies in place. One staff member said, 'The protocols around DoLS are very clear, we have forms and now how to submit them.' We looked at the safeguarding training and refreshers. We saw that training in safeguarding had been provided for all staff. One staff member said, 'All staff are very confident in how to raise concerns and would not hesitate to raise them.' Another said, 'We have all been reminded of raising concerns however little as it is important for our residents to feel safe and supported.' One person who used the service said, 'Staff always ask me if I am okay, I would tell them if I was unhappy with anything.' Another said, 'I would speak to staff nurse in charge if I was treated harshly.'

Is the service effective?

A new daily call bell monitoring audit had been introduced and was seen to be effective in reducing risk to the people who used the service.

People were supported by staff that had the necessary skills and knowledge to meet their assessed needs. Staff had up-to-date training and supervision and staff were encouraged to progress professionally.

Is the service caring?

People and visitors told us that the staff were kind and attentive. We saw that staff showed patience, compassion and understood how to support people as individuals. Our observation found that staff knew how to communicate effectively with people and we saw staff answer call bells in a timely manner.

Is the service well-led?

The service had robust quality assurance systems that is now embedded into practice. We saw that comprehensive audits were kept in respect of wounds, infections, call bell response, care documents and accidents. These were monitored carefully by the manager and the organisation. Records showed that identified shortfalls were addressed promptly and the quality of the service had improved.

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, our observations made during the inspection and the records we looked at.

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

Is the service safe?

There was sufficient equipment at the service, which was well maintained and serviced regularly. People were cared for in an environment that was safe, clean and hygienic, although we told the provider we found that some of their cleaning records had lapsed.

Systems were in place to make sure that all staff learnt from events such as accidents and incidents, complaints, concerns and adverse inspection findings. Feedback was sought from people and their relatives and acted upon. This helped reduce risks to people and enabled the service to improve.

CQC monitors the operation of the Deprivation of Liberty safeguards (DoLS) which apply to care homes. This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted at Grosvenor Park, we found that suitable policies and procedures were in place. Documents in people's care plans showed that their mental capacity had been assessed in areas such as day to day decision making. This provided a basis for monitoring people's mental health and meant that they had been safeguarded as required. One person we spoke with told us 'I feel safe and settled here'.

Is the service effective?

People told us they were happy with the care delivered and their needs had been met. Our observations and speaking with staff showed that they had a good understanding of people's care and support needs and that they knew them well. A visitor we spoke with told us they were 'Happy with the care' their relative received.

Where people needed equipment, such as walking aids and hoists, to support their mobility or to assist in transferring them form one position to another, we saw that it was available, serviceable and in use.

Is the service caring?

People and visitors told us that the staff were kind and attentive. Care records contained personalised information which helped staff to know the people they supported and how to meet their needs. We saw that care workers showed patience, compassion and understood how to support people as individuals. One person told us 'I'm happy that I live here'. Our observation found that staff knew how to communicate effectively with people and we saw how this helped to reduce one person's anxiety and meet their needs.

Is the service responsive?

People's needs had been assessed before they moved to Grosvenor Park. This meant that the service had the skills and facilities to meet their identified needs. Regular monitoring of people's health, associated risks and their social needs identified when particular measures were required to help keep people safe. We saw that, when identified, such measures were put in place. This meant that the service was responsive to people's individual needs. Records confirmed people's preferences and care and support had been provided in accordance with their wishes. However, we told the provider that some information in people's care plans was contradictory and could potentially lead to a serious mistake being made about if a person wished resuscitation attempts to be made.

Is the service well-led?

The service had recently introduced an improved quality assurance system that is now embedded into practice. Records showed that identified shortfalls were usually addressed promptly and the quality of the service had improved. However, we told the provider that management checks had not identified that some cleaning records were incomplete. Discussion with staff found that they had a good understanding of their responsibilities and of the values of the service.

People were enabled to express their views and were involved in making decisions about their care and treatment. We found that care and treatment was planned and delivered in a way that ensured people's safety and welfare. We saw documentation that the provider responded appropriately to any allegation of abuse. The home was clean and hygienic with systems in place to prevent cross infection. There were enough qualified, skilled and experienced staff to meet people's needs. We saw that complaints were taken seriously and there was an effective complaints system available