All inspections: Florence Grogan House Residential Care Home

This was an unannounced inspection, carried out on 25 and 26 August 2015.

Florence Grogan House is a residential care service over two floors, which provides accommodation and personal care for up to 40 people including 10 people living with dementia. Access to the upper floor is via a passenger lift or stairs. Local shops and other amenities are a short distance away from the service and there are good public transport links close by. At the time of our inspection there were 37 people living at the service.

The service has a registered manager. 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 last inspected this location in August 2013 and we found that the registered provider met all the regulations we reviewed.

At this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We found that improvements were required in how people’s care and support needs were assessed and planned. Care plans we reviewed lacked detail and were not personalised about how to meet the person’s needs.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Not all staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) but were able to show a basic understanding of the key principles when asked. Care plans did not identify how decisions for people who lacked capacity, were made in their best interests.

We have made a recommendation about recording decisions in line with the MCA code of practise.

People received their medication as prescribed and staff had completed competency training in the administration and management of medication. Two people’s medication administration records (MAR) had not been appropriately signed or coded when medication was given.

Systems were in place to check on the quality of the service but records we saw were not regularly completed in line with the registered providers own timescales. We were not notified as required about some incidents and events which had occurred at the service.

People were safe and staff understood what is meant by abuse and they were aware of the different types of abuse. Staff knew the process for reporting any concerns they had and for ensuring people were protected from abuse. Family members told us they had no concerns about their relative’s safety. They commented; “I know that my family member is safe and that if there are concerns they will contact me and let me know. They all treat [my relative] with respect and as if she is one of their own family members”. Staff told us they would not hesitate to raise concerns and they felt confident that they would be dealt with appropriately.

Robust recruitment processes were followed and there were sufficient qualified, skilled and experienced staff on duty to meet people’s needs.

Staff were caring and they treated people with kindness and respect. People were happy with the care that they had received. They told us that staff always treated them as individuals and were mindful of their privacy and dignity and helped them to maintain their independence. Relatives and visitors told us that they had no concerns about the care that they observed. They said they had always been made to feel welcome and they felt that the service was homely.

Staff worked well with external health and social care professionals to make sure people received the care and support they needed. People were referred onto to the appropriate service when concerns about their health or wellbeing were noted.

Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.

The premises were accessible, clean, safe and free from unpleasant odour and staff were able to describe their responsibilities for ensuring people were protected against any environmental hazards.

We looked at three care plans and other care records and people all had an assessment of their health and social needs completed. The care plan documentation was up to date, but we found the recording of activities was not up to date.

We spoke with five people who used the service, two relatives, three staff and two professionals involved in the service. People who used the service said 'The home is clean', 'The staff are very good' and 'I am well cared for.' Relatives commented 'The staff are lovely and pleasant' and 'I have no concerns and I am very happy with the home.' All the people spoken with said they didn't have any concerns or complaints.

Staff commented 'The staff team get on well together', 'We have regular staff meetings', 'The staff team are friendly and supportive' and 'The management team are helpful.' Other professionals commented 'The people here seem well cared for', 'The home is always clean', 'I have no concerns or complaints' and 'The staff are efficient and well trained.'

We looked at staffing levels at the service. We saw the rota and discussed staffing issues with the manager.

We saw that Florence Grogan House had not received any complaints since the last inspection and the Commission had not received any complaints about the service.

We saw interactions between the people who lived at the home and staff and found a relaxed and friendly atmosphere between them. During a tour of the building we found it was clean and odour free.

During our inspection we found that the people living at Florence Grogan House looked well cared for and were dressed appropriately for the weather on the day. The people using the service who were able to tell us said that they were happy living in the home. Comments included; 'It's lovely here', Staff are very kind.' Two visiting relatives told us, 'We are very happy with the care and the staff.'

The home had an adult protection procedure [now called safeguarding] that complied with all of the relevant legislation and good practice guidelines. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

There was a consistent team of staff within the home and we do not have any concerns regarding either their numbers or suitability. The staff members we spoke to were very positive about the home. Comments included; 'I love my job' and 'There is a friendly atmosphere.' We asked the people living at Florence Grogan House about the staff working there, comments included, 'Staff are very kind.'

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis from feedback from the people who used the service and their representatives, including their relative's and friends, where appropriate. Comment forms and a post box are in the entrance area if people choose to use them.

People we spoke with during this visit told us they were happy with the care and support provided. Other people commented, 'The staff are very nice', 'I like living here', 'The staff are friendly' and 'It is very nice here and the staff are good.'

We observed the lunchtime meal being served and saw that people who needed support with their meal were offered help throughout the meal. Staff supported people in a caring and sensitive manner.

During this visit we spoke to some of the relatives who were visiting people who use the service and they said, 'The home is great and I have no concerns. The staff are very kind and gentle with the residents', 'My relative receives a very high level of care', 'The staff are friendly. The front door is always opened promptly. The home is exceptionally clean. Thank you for your wonderful care' and 'Expressing thanks for the birthday party. The food and entertainment was wonderful.'

We spoke with staff during our visit and they all said that they enjoyed working at the home and that the people who live there are always considered first. Other comments included, 'The activities coordinator explained that she did different types of activities with people on each unit and tended to do more one to one work with people on the dementia care unit. She enjoys her job very much. She said the manager is very good and that she gets on well with her. She said that she gets good support with arranging activities. She also commented that the staff team are very good and they all work together well. Many of the staff will come into the home to support activities in their own time', 'I like working here. The manager is fair and approachable. The staff team are good and we support each other. I have been on a range of training and just completed my NVQ level 2 which I really enjoyed' and 'I like working here. The manager is great ' no problems. The staff team are lovely. It is like a small household, very friendly. We work around the people who live here and don't have set routines. The training is very good here and I have undertaken many courses.'

On discussions with the staff team it was evident that they were aware of the peoples needs and that they had taken time to get to know them well. They described the support that different people need within the home and that each person is an individual with needs that are specific to themselves. Routines within the home are not set to rigid times and this seems to work well here. Also staff showed their knowledge and understanding of adult abuse and what they would do if they suspected abuse of a resident.

A visiting professional we spoke with on the day of the visit commented, 'The home has very high standards. I am always met at the front door. The staff are very approachable and they listen to advice that is given. The manager is very good she is approachable and friendly. There is good communication in the home and it has a good reputation in the area.'

Archived: Florence Grogan House Residential Care Home

All Inspections

25 and 26 August 2015

During a routine inspection

8 August 2013

During a routine inspection

15 February 2013

During a routine inspection

17 January 2012

During a routine inspection