Grosvenor Court

Updated 24 May 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned based on the rating of the last inspection to check whether the provider continued to meet the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a current rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two inspectors on the first day and one inspector on the second day.

Service and service type:

Grosvenor Court is a care home that provides accommodation and personal care for up to 13 people who have a learning disability, autistic spectrum disorder and some physical disabilities. People in a care home receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager. This means that they are registered with the Care Quality Commission and with the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The first day of the inspection was unannounced.

What we did:

Before the inspection the provider completed a Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report. We reviewed the information we held about the service including previous inspection reports. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.

Not everyone living at Grosvenor Court could tell us about their experiences living of there. We spoke with two people, and spent time observing staff with people in communal areas during the inspection. We spoke with the registered and deputy manager, three staff, the cook and maintenance. After the inspection we spoke with one person’s relative to gain feedback about the care and support their family member received.

During inspection we looked at the following:

We reviewed some records, these included four care plans as well as people’s medicines charts, risk assessments, staff rotas, staff schedules, four staff recruitment and supervision records, meeting minutes, policies and procedures. We looked at training records of all staff. We also reviewed some records relating to the quality and management of risk within the home.

• The environment, including the kitchen, bathrooms and people’s bedrooms

• We met each person and spoke to two people living at the home

• We spoke to two care workers, one team leader, the deputy manager and the manager

• Four people’s care records

• Medicines records

• Records of accidents, incidents, complaints and compliments

• Quality assurance processes and audits

• Deprivation of Liberty records

• Staff training records

• Fire, health and safety and maintenance records

We asked the registered manager to send us additional information after the inspection. We asked for copies of a gas safety certificate, a statutory notice and an authority form a GP or pharmacist to administer some pills in a different way to how they were received. The registered manager responded in a timely way forwarding the information required.

Updated 24 May 2019

About the service:

Grosvenor Court accommodates up to 13 people. At the time of our inspection, 8 people were staying at the service. The service provides for people with learning disabilities or autistic spectrum disorder and people with physical disabilities.

The service had been registered before the development of guidance and values which are currently considered and underpin the Registering the Right Support. However, the values that underpin the guidance such as offering choice, promotion of independence and inclusion were evident in the support people received from staff so they can live as ordinary a life as any citizen.

People’s experience of using this service:

• At our last inspection in August 2018 people did not always receive the support they needed.

• There was no registered manager in post, there were not always enough staff on duty and staff recruitment processes were not robust.

• Guidance for people with epilepsy needed improvement and medicines were not always available or always stored in line with guidance

• Records to reduce risks of dehydration were incomplete and security, fire and maintenance arrangements were not effective.

• Management audits and quality improvement checks had not identified some areas of concern or addressed some issues previously pointed out.

• After this inspection we issued two warning notices telling the provider the improvements needed and by when. The provider sent us an action plan setting out how they would they would do this.

• At this inspection significant improvement had been made, a registered manager was now in post and the breaches in regulations identified at the last inspection were now met.

• Systems to assess, monitor and improve the service were robust; the provider had invested in the maintenance of the service and the improvement in governance had impacted positively on the culture of the service.

• The quality of care people received had significantly improved since the last inspection, records were up to date and reviewed, guidance was in place for staff to consistently support people.

• Medicines practice had improved. The management team continuously reviewed medicines practice, including availability and storage to ensure people received their medicines safely.

• There were sufficient staff and recruitment practice had improved. The provider had carried out suitable checks to ensure staff were suitable to work with people.

• Feedback from a relative and our observation of the care provided were positive.

• Communication from staff was good and we saw the registered manager and staff were approachable. People and relatives commented on the caring attitudes of staff. People and relatives felt able to raise concerns if they had them.

• There was a positive atmosphere at the service. People were happy, and staff engaged with people in a kind and caring way. People were busy when we visited and engaging in activities.

• Staff were kind and caring, they had the skills and training needed to support people and were supported by the registered manager. People were encouraged to increase their independence and the service supported people to maintain relationships with family and friends.

• The registered manager and staff worked with a clear vision for the service.

Please see more information in Detailed Findings below.

Rating at last inspection:

At the last inspection on 7 and 8 August 2018, the service was rated as Requires Improvement. At this inspection we found the service had improved to Good overall.

Why we inspected:

This inspection was part of our scheduled plan of visiting services based on their previous rating to check the safety and quality of care people received.

We will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.

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