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Archived: Granvue Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 December 2018

This unannounced inspection took place on 30 October and 1 November 2018. Granvue is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service does not provide nursing care.

Granvue offers short stay care and support for up to eight people with mental health needs who may require a short-planned admission. Granvue allocated three of these beds for people who were in need of urgent mental health crisis care; these were for people who were referred to the service through the local NHS crisis team. At the time of the inspection there were three people living at the service.

Granvue was previously inspected in December 2017, when the service was rated as ‘requires improvement’ overall. Following that inspection, the provider sent us a plan describing the actions they had taken to improve. At this inspection, in November 2018, we found improvements had been made in relation to services risk management systems, such as those associated with people's complex mental health, staff recruitment, training and the service’s quality assurance systems. However, we found improvements were still needed.

We looked at the service’s quality assurance and governance systems and found where monitoring arrangements had previously failed, improvements had been made. However, whilst some systems were working well, others were still not being used effectively or undertaken robustly enough to identify the issues seen at this inspection. For example, whilst some premises checks had been completed there was no evidence to show that any action had been taken as a result or that the information was being reviewed.

Granvue had a registered manager who, at the time of the inspection was taking a period of leave. An interim manager had been appointed by the provider and the nominated individual was overseeing the service in the registered managers’ absence. 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. Staff told us they felt supported by the new appointed manager.

People’s medicines were not always stored or managed safely. We found the service did not have a robust system in place to ensure that people or unauthorised staff could not access people’s medicines. Although the service had clear procedures in place for recording what medicine had been received or given to a person. We found staff were not always following these procedures as records were not consistently completed.

People were encouraged to make choices and were involved in the care and support they received. Staff displayed a good understanding of the principles of the Mental Capacity Act 2005 (MCA). However, we found that some systems and processes did not support the management of the home in protecting people’s rights. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). At the time of the inspection we found people could come and go as pleased. However, staff did not fully recognise that the provider had implemented a policy which meant some aspects of people's care had become potentially restrictive. We discussed what we found with the nominated individual and when we returned on the second day of our inspection we found the policy had been withdrawn and the checks had stopped.

People received a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe f

Inspection areas

Safe

Requires improvement

Updated 13 December 2018

Some aspects of the service were not safe.

People were not always protected from the risks associated with the management of medicines.

People felt safe and staff knew how to protect people from abuse.

Risks associated with people’s complex care had been assessed and were well managed.

People were protected by a robust staff recruitment process.

There were sufficient numbers of suitably qualified staff to meet the needs of people who lived at the service.

Effective

Good

Updated 13 December 2018

The service was effective

People’s consent was gained before care and support was delivered.

People were cared for by skilled and experienced staff who received training and supervision, and were knowledgeable about people’s needs.

People were referred to healthcare services and professionals were involved in the regular monitoring of their health.

People were supported to maintain a balanced healthy diet.

Caring

Good

Updated 13 December 2018

The service was caring.

People were positive about the support they received and felt staff were kind, caring and treated them with respect.

People's privacy and dignity was respected and their independence promoted.

People were offered choices in how they wished their needs to be met.

People were supported to maintain relationships with family and friends.

Responsive

Good

Updated 13 December 2018

The service was responsive.

People’s support plans were personalised with their individual preferences and wishes taken into account.

People’s risk of social isolation was recognised by staff who supported people to overcome this.

People were confident that should they have a complaint, it would be listened to and acted upon.

Well-led

Requires improvement

Updated 13 December 2018

The service was not always well-led.

Although quality assurance systems were in place, they were not being used effectively or undertaken robustly enough to identify the issues seen at this inspection.

People’s care records were accurate and up to date.

The nominated individual was well regarded by people and staff.

The service had notified the CQC of incidents as required by law.