Archived: Grovewood House

Updated 1 August 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The team consisted of two inspectors and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service; this expert by experience had knowledge of older people.

Service and service type:

Grovewood House 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager and the provider were not available throughout the inspection process.

Notice of inspection:

This inspection was unannounced.

What we did:

Before the inspection we used information about the service to plan. We reviewed notifications sent us to us about certain incidents that had occurred that the provider must tell us about. We reviewed the information the provider sent us in their last Provider Information Return. This is information we require providers to send us, for example what works well, and improvements planned. We contacted the local authority commissioning and safeguarding teams, the infection control lead for care homes in the area, the local fire authority and the local Healthwatch. Any comments received supported the planning and judgements of this inspection.

During the inspection we spoke with nine people who used the service and two relatives. We spoke with the assistant deputy manager, the administrator, one cook, two senior care staff, five care staff, one agency member of care staff, one domestic and a visiting community nurse. We also contacted the medicine optimisation team and two care managers.

We looked at seven people’s care records, and medicines records for 17 people. We also looked at records relating to the management and quality assurance of the service.

Updated 1 August 2019

About the service: Grovewood House is a residential care home that provides personal care for up to 28 older people. At the time of the inspection 20 people were being supported, some of whom lived with dementia.

People’s experience of using this service: There were major shortfalls in the leadership and management of the service. The provider and registered manager failed to adhere to regulatory requirements. Robust governance arrangements were not in place. Audits and checks had not always been effective in driving necessary improvements.

When we inspected the registered provider confirmed they were no longer carrying on the regulated activity and a third party was overseeing the management of the service. The registered provider and registered manager were not available throughout the inspection and did not respond to feedback given after the inspection had been concluded. People and their relatives told us that the provider and registered manager had not communicated well with them about changes taking place at the service.

We found gaps in risk monitoring which needed to be addressed. Actions regarding fire safety were still to be completed. Staff knew how to protect people from abuse, but some lacked vital training.

Policies and procedures were not properly implemented.

Staff recruitment was not always safe. Staff were not properly inducted or suitably trained and supervised to ensure they had the skills and competence to carry out their role.

Records were not always accurate or complete. We were unable to tell from records whether people received their medicines as prescribed.

The service was clean and tidy, but further work was needed to fully refurbish and finalise the décor of the building.

People and their relatives said that staff were kind and caring. Various events and entertainment took place but a gap in day to day activities was evident.

A good selection of home cooked foods was available to meet people’s dietary requirements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice, although recording needed to be improved.

We have identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Inadequate (Report published on 30 November 2018).

Why we inspected: This was a planned inspection based on the previous rating, and to follow up on two warning notices issued.

Enforcement: Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up: The overall rating for this service is ‘requires improvement’ but with a continuing rating of inadequate in well led and therefore the service remains in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check or significant improvements.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.