Grosvenor Lodge

We found the following examples of good practice.

The home was clean and tidy. A housekeeping checklist was followed to ensure all cleaning tasks were consistently completed. This included frequent disinfection of areas which were regularly touched, for example, door handles. Care staff assisted with the cleaning of the home.

The service had increased staffing levels to support with activities in the home and minimise the risk of social isolation. For example, a pamper/grooming session was created so people could wash their hands whilst having a hand massage or a manicure.

There was a separate entrance for staff and for visitors. Hand-washing facilities were outside the home. Visitors had their temperatures taken and completed a questionnaire before entering the home. Personal protective equipment (PPE) was available at both entrances.

An online booking system was in place to arrange both in-person visits and virtual calls. The registered manager had contacted those who did not access the internet to arrange visits. People were also supported to access the community where they could also meet their friends or family. Visits had been temporarily placed on hold due to a second national lockdown.

The provider had purchased bicycles for staff to use as an alternative to public transport to minimise the spread of infection. They also had a private car available to drive staff to work if needed.

Staff were wearing appropriate PPE in-line with government guidelines. Staff had completed infection prevention and control (IPC) training. The registered manager had undertaken additional IPC training to support staff with best practice.

Further information is in the detailed findings below.

Grosvenor Lodge is a residential care home providing personal care for up to 31 older people some of whom were living with dementia. There were 30 people living at the service during the inspection.

Grosvenor Lodge accommodates 31 people in one adapted building. There were three shared lounges, a dining room and accessible garden.

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

Risks to people were not always appropriately recognised and assessed. Risks around people’s health diagnoses, behaviour that may challenge and specific healthcare aids had not always been recognised and planned for. When people’s behaviour could challenge, this was not always recorded and monitored appropriately. Safeguarding was not always reported appropriately when people displayed behaviour that challenged which affected other people.

People were not always supported to have maximum choice and control of their lives and staff did not support always them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

The quality assurance framework was not effective and had not supported the provider to identify and address the areas needing improvement. There was no guidance in place for medicines which were prescribed ‘as required’ (PRN). Staff were supported when they began administering medicines, and their competency to do this was checked, but this was not recorded.

People were treated with kindness, dignity and respect and encouraged to express their views and be involved in their care. One person told us, “It’s my favourite place to come to.” Another person’s relative said, “I'm happy that she is safe and well looked after.”

People’s needs were assessed before they moved into the home. Care plans included people’s life histories, hobbies and interests. When appropriate, people’s preferences for the end of their lives had been discussed with them and their relatives.

There were enough staff available to meet people’s needs. Staff were recruited using safe recruitment methods and supported with induction, training and regular supervision. Staff told us they felt supported by the management team.

People were supported to eat and drink, staff knew about anyone with specialist needs around food. People were supported to access health care support as needed. Staff worked in partnership with other agencies and professionals to support people.

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 (9 March 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches of regulation in relation to the governance of the service. The provider failed to ensure that they had assessed, monitored and mitigated the risks relating to health, safety and welfare of people and others. The provider had not ensured that an accurate, complete and contemporaneous record in respect to each person had been kept.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

One service user told us 'I'm very happy to be here, the care is good.' Another service user said 'I get on with the staff,' and, 'I think they're pretty good.' A third service user we spoke with said 'I love it here.'

A family member told us 'Staff are friendly and helpful. The care is personalised and it is 'caring' care. The manager is good and there is a real relationship between the staff and my relative.'

A visiting local authority care manager told us that the service user they were reviewing six weeks after arriving at the home had 'really settled in well,' and that the home had a 'stable core team and feels like a family.'