23 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 23 and 29 November 2017 and was unannounced. The inspection was carried out by one inspector.
Prior to the inspection we looked at the information we held on the service including notifications of significant events and safeguarding. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about. We also contacted the local authority’s learning disability team to gather information about their experience of the service.
During the inspection we spoke with one person using the service, one relative, the director and two care workers. We viewed the care records of two people using the service and three care workers files that included recruitment, supervision and appraisal records. We looked at training records for all five care workers. We also looked at medicines management for two people who used the service and records relating to the management of the service including service checks and audits. After the inspection we spoke with two relatives.
23 December 2017
This comprehensive inspection took place on 23 and 29 November 2017 and was unannounced. The last inspection took place in January 2017 and the service was rated ‘requires improvement’ in Safe, Effective, Well Led and overall. Caring and Responsive were rated ‘good’. We found breaches of Regulations relating to safe care and treatment, consent to care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when they would make the necessary improvements to meet regulations. During this inspection, we found that improvements had been made.
Grosvenor House is a ‘care home’ for up to six people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection, two people were using the service.
The previous registered manager left the service in August 2017. The director, who was also a shareholder in the service, had employed a new manager who was due to begin working with the service in December 2017 and the expectation was that they would apply to CQC to become the 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.
During the inspection we found, the provider had not been notifying the Commission of the applications they had made and the outcomes of these applications for authorisations to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS). This was addressed promptly following the inspection and the director said this was an oversight. However, the provider's quality assurance systems had not identified that these notifications had not been submitted to the Commission as required by law.
The provider had procedures in place to protect people from abuse. Care workers we spoke with knew how to respond to safeguarding concerns. People had risk assessments and management plans in place to minimise risks and incidents and accidents were recorded appropriately.
Care workers followed procedures for the management of people’s medicines and underwent medicines training and competency testing. Weekly medicines audits indicated that people were receiving their medicines safely as prescribed.
Care workers had completed training in infection control and used protective equipment as required.
Care workers had an induction, up to date relevant training, supervision and annual appraisals to develop the necessary skills to support people using the service. Safe recruitment procedures were followed to ensure care workers were suitable to work with people using the service.
People were supported to have maximum choice and control of their lives and care workers were responsive to individual needs and preferences.
People's dietary and health needs had been assessed and recorded and were monitored.
People and their families, were involved in their care plans and making day to day decisions. Care plans contained the required information to give care workers guidelines to effectively care for people in their preferred manner.
There was a complaints procedure in place, however the service had not had any complaints since the last inspection. The director was available at the service and stakeholders told us they were approachable and supportive.
The service had a number of systems in place to monitor, manage and improve service delivery so a quality service was provided to people. This included a complaints system, service audits and satisfaction surveys.