The inspection took place on 20 September and 22 September 2016 and it was unannounced.
Victoria Grand is registered to provide accommodation and personal care for up to 26 people. At the time of the inspection 21 people were living at the home, this included two people staying on short breaks. People had various needs including dementia and physical disabilities.
Victoria Grand is an older styled detached property situated close to the centre of Worthing with easy access to shops and the seafront. Some areas of the home, including the entrance and dining area had been decorated and were warm and inviting. There was an action plan in place which included areas of the home which remained in need of decorating. The house was surrounded by additional space including a large attractive garden to the side of the building. All bedrooms were personalised and single occupancy and had en-suite facilities.
A registered manager was in post at the time of our inspection who had managed the service for many years. 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 unable to demonstrate that the Mental Capacity Act 2005 (MCA) had always been followed because capacity assessments had not been completed by staff on behalf of people. Best interest meetings were held in line with the (MCA) and the Deprivation of Liberty Safeguards (DoLS) legislation for one person who lacked capacity to make decisions over their care. However, this practice was not consistent as this had not been considered for another person who was deemed to lack capacity to make a decision regarding the use of bed rails on their bed. The registered manager was able to tell us the action she had taken with regard to this.
People and their relatives told us the home provided a safe service and there was enough staff to meet people’s needs. Staff were able to speak about what action they would take if they had a concern or felt a person was at risk of abuse. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks.
People’s medicines were managed safely and administered by staff who had received specific medicine training. The home followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their role.
Staff implemented the training they received by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the registered manager.
People could choose when, where and what they wanted to eat. Additional drinks and snacks were observed being offered in between meals and staff knew people’s preferences. Staff spoke kindly to people and respected their privacy and dignity. Staff knew people well and had a caring approach.
People received personalised care. Care plans reflected information relevant to each individual and their abilities, including people’s communication and health needs. Staff were vigilant to changes in people’s health needs and their support was reviewed when required. If people required input from other health and social care professionals, this was arranged. People were offered activities to attend within the home. All complaints were treated seriously and were overseen by the registered manager.
People were provided opportunities to give their views about the care they received from the service. Some people chose to use these opportunities to become more involved with their care and treatment. Relatives were also encouraged to give their feedback on how they viewed the service.
Staff understood their role and responsibilities. The registered manager demonstrated a ‘hands-on’ approach and knew people well. They had implemented a range of quality audit processes to measure the overall quality of the service provided to people and to make improvements.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.