Granville Lodge

People's experience of using this service and what we found

All staff understood their responsibility to keep people safe from harm. Risks to people had been assessed with actions in place to help keep people safe. There was enough staff to safely provide care and support. Checks were carried out on staff before they started work to assess their suitability. Medicines were well managed, and people received their medicines as prescribed.

There were two managers registered at the service, both were knowledgeable and enthusiastic about the home. They felt supported within their role. Staff described working together as a team, they provided person-centred care and helped people to achieve their potential. There was a programme of audits in place to assist the management team to identify and address shortfalls.

Rating at last inspection

The last rating for this service was good (published 26 September 2018).

Why we inspected

This inspection was carried out as the home had not been inspected since the 2 and 3 August 2018. We undertook this focused inspection to check the service was Safe and Well-Led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Granville Lodge on our website at www.cqc.org.uk.

We found the following examples of good practice.

People we spoke with told us, “We have felt very safe here, I for one am glad I had my vaccines before I came here”, “I choose to wear a mask when I am walking in the corridors or I am in a room with people, it’s my decision and makes me feel safer”, “The staff always wear a mask”, “They have been kind and caring” and “They have things in place which is good”.

The staff that were spoke with told us, “The last two years have been hard at times, but we have supported each other and team work is even better”, “We have always been kept up to date with changes and new guidance”, “We have worked hard to keep people safe”, “I have made changes in my personal life so that I am exposed to less people, it is my responsibility to protect the residents”, “I personally feel supported by the provider and the RM they have been good to me”.

The home was visibly clean and hygienic and regular cleaning schedules were maintained by house keeping staff to evidence regular cleaning tasks were being completed. Staff had received training in relation to infection prevention and control and were observed following current guidance in the use and disposal of PPE. PPE stations were located throughout the home.

There was a clear process for visitors. This included sanitising hands on arrival at the home. Visitors were required to have their temperature taken and were asked if they had any symptoms. They were asked to wear PPE which included a face mask.

Visitors were required to sign in and they had to show a negative lateral flow test. The vaccination status was checked for health and social care professionals and contractors. This was in line with legislation that had come into effect in November 2021.

People were supported to see friends and family in accordance with government guidance. This was by pre booked appointment. In the event of a Covid outbreak or if people were isolating, they were supported to maintain contact by the telephone and video calls. Relatives of people coming to the end of their lives were supported to visit safely.

The registered manager told us people’s significant others had been asked if they wanted to become the essential carer giver for their relative. This meant they will still able to visit during an outbreak at the home. In order to become an essential care giver, set procedures were to be followed. This included participating in regular testing for Covid.

All staff had received training in relation COVID-19, infection prevention and control, hand washing and the donning and doffing of PPE. Information and ongoing government guidance in the management of COVID-19 was shared with staff.

The home took part in regular testing for COVID-19. The registered manager maintained an audit of the dates staff and people were last tested. The registered manager told us all staff had been double vaccinated. Some staff had received booster vaccinations and others planned to have this when they were able to. The Covid passports of staff had been checked by the management team.

The registered manager told us they were not experiencing any workforce pressures and that staffing was manageable. At the time of the inspection the home had 11 vacant beds. Staffing levels had been maintained. We were told the home did not use agency staff. They had a good core team of staff that liked to pick up extra hours as overtime. This was monitored to ensure staff were not over worked.

The home had established good working relationships with relevant healthcare professionals and their support continued during the pandemic.

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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008.

Granville Lodge provides accommodation for people who require nursing or personal care for up to 81 people. At the time of our visit there were 73 people living at the service.

People were protected from abuse because staff understood how to keep them safe, including understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.

There were enough suitable staff to meet people's needs.

People's safety had been considered by the service, risk assessments both for care and the environment had been completed.

Staff recruitment procedures were safe and the employment files contained all the relevant information to help ensure only appropriate staff were employed to work at the service.

People received their medicines when they required them and in a safe manner. Staff received training and guidance to make sure they remained competent to handle people's medicines.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 (MCA) and the DoLS. Staff had the right skills and training to support people appropriately.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported to eat and drink according to their likes and dislikes. People's nutritional needs were reflected in care plans and we observed staff supporting people to ensure their health and wellbeing was maintained.

Staff were caring, kind and treated people with respect. Staff were described as caring by people's relatives. The registered manager and staff were held in high regard and we received positive comments about the service they provided.

People's personal and health care needs were met and care records guided staff on how to do this. There was a variety of activities for people to do and take part in during the day, and people had enough social stimulation.

The service supported people to maintain their health and wellbeing and people were supported to access healthcare services and any treatment required promptly.

There was a system in place for responding to and acting on complaints, comments, feedback and suggestions.

People and their relatives praised the management of the service. They said the team were approachable and had a visible presence at the service. The views of people and their relatives and staff had been actively sought to develop the service. Effective arrangements were in place for the service to learn, improve and assure its sustainability. Strong partnerships had been developed with other agencies for the benefit of people who used the service.

Quality assurance systems were in place to assess and monitor the quality of service that people received and identify any areas that required improvement.

Granville Lodge is a care home with nursing care for up to 81 predominately older people. People have general nursing care needs and some are living with dementia. At the time of our visit there were 75 people living at the home.

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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008.

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

Appropriate moving and handling techniques were not used by staff. Moving and handling equipment was not used safely by staff.

Checks were not always carried out on some equipment within the premises. Some safety equipment had not been maintained and repaired in a timely manner.

We observed poor care practices in relation to dignity and respect. People’s dignity and wishes were not always respected by staff.

We found that the home had systems in place to assess and monitor the quality of service. However, they were not always effective. We had identified areas that require improvement, which were not picked up by the quality assurance processes.

Staff were knowledgeable about recognising the signs of abuse. All staff had received training in safeguarding adults.

Medicines were administered to people safely by staff that had been trained.

There were sufficient numbers of staff to ensure people's needs were met. The registered manager carried out pre-employment checks on staff before they worked with people to assess their suitability.

The home was meeting the requirements of the Deprivation of Liberty Safeguards. Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

Staff received induction and training. A training programme was in place and staff had been encouraged to complete all mandatory refresher training. Staff had supervision meetings and team meetings were held to support them in their role.

People were satisfied with the quality of the food and drinks provided. Food and fluid intake was monitored where risks of weight loss or dehydration had been identified. Arrangements were made for people to see their GP and other healthcare professionals as and when they needed to do so.

People said they were treated in a kind and caring manner. People were able to make choices about the way they were cared for.

Activities were personalised for each person. People made suggestions about activities they wanted to participate in each day.