Grasmere Nursing Home

Updated 22 June 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors.

Service and service type

Grasmere Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Grasmere Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. There had not been a registered manager in post since June 2022. The provider was in the process of recruiting a new registered manager

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on 11 August 2022 to help plan the inspection and inform our judgements.

We used all this information to plan our inspection.

During the inspection

We spoke with 4 people, 2 relatives, and a friend of a person living at the home, about their experience of the service. We spoke with the provider who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the nurse on duty, the cook and 2 care staff.

We reviewed a range of recordings including 7 care plans and multiple medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 22 June 2023

About the service

Grasmere Nursing Home is a nursing home providing nursing and personal care to up to 20 people with a range of health care needs, including people who were coming to the end of their lives and people with complex medical conditions. At the time of our inspection, there were 15 people using the service.

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

Risks to people had not always been identified, assessed, and documented to ensure they were protected from avoidable harm. Care plans lacked information and guidance for staff on how to manage risks or how to support people safely. There not been a registered manager in post since June 2022, although there were plans to recruit one. Auditing systems were not effective in monitoring or measuring the quality of the service overall to drive improvement.

People told us they felt safe living at the home. Staff knew people well and were attentive to their needs. People received their medicines as prescribed, and medicines were managed safely. There were enough staff to look after people. Visitors to the home were made welcome.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 28 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook a focused inspection to review the key questions of safe and well led only. 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 has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this report.

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

Enforcement

We have identified breaches in relation to the identification and assessment of risks to people, monitoring, oversight, governance of the service and due to the provider not having a registered manager in post.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.