6 February 2015
During a routine inspection
This inspection took place on 6 February 2015 and was announced. We provided the registered manager with 24 hours’ notice of our inspection. This was because the registered manager manages other locations supporting staff and is often not at the service. We needed to be sure that they would be in.
100 Grosvenor Terrace is a residential care home which provides accommodation and personal care for up to four adults with complex health needs and learning disabilities. At the time of the inspection there were four people living at the service.
There is a registered manager at the service. 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 service was not well led. The service did not always carry out audits to improve the care delivery for people. We found that the service carried regular audits and acted on outcomes to make improvements to the service. However, we found that the service had not carried out an overall audit of medicines; therefore the registered manager did not have an overview of the management of medicines. We have made a recommendation about the management of some medicines.
Despite this medicines were managed safely and medicine administration records were accurate and up to date. Staff carried out medicine audits at each shift change.
Staff were aware of what actions to take to protect people from abuse. Staff were of the signs of abuse and how to escalate an allegation of abuse to their manager and the safeguarding department of the local authority.
People received a safe service that assessed risks to their health. Staff developed and implemented plans to reduce occurrence of those risks for people.
The service employed skilled staff who could meet the needs of people, newly appointed staff worked with experienced staff to develop their caring skills.
Staff had regular training, supervision and appraisal to support and equip them in their caring role.
Staff were aware of their responsibilities of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were supported to consent to care and their relatives were involved in making complex decisions, where required.
People had assessments completed before coming to live at the service to ensure that staff could meet their needs. Staff were experienced in caring for people with complex needs and were able to communicate with people they cared for. Staff engaged well with people and we saw that people responded well to staff. People were supported to participate in activities outside of the home and they were encouraged to be as independent as possible. People’s confidential records were kept safe and secure.
Care and support was delivered to meet people’s care needs. Care plans were used to meet people’s needs and to provide appropriate care.
People and their relatives were encouraged to provide feedback on the quality of the service provided and staff acted on those comments received. People and their relatives were provided with information on how they could make a complaint and how their complaint would be managed by staff.
The registered manager was aware of their responsibilities of managing the service and of their registration with the Care Quality Commission.
Staff used incidents and accidents at the service as learning opportunities during team meetings to improve the service to people.