Grosvenor House

Updated 4 October 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 was planned to check 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.

We inspected the service on the 4 and 5 September 2017. This was an unannounced inspection. One inspector and an expert by experience undertook the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We last inspected the service in July 2016 where we found the service required improvement and was in Breach of four Regulations.

We reviewed the information we held about the home, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We reviewed the Provider Information Return (PIR). This is a form in which we ask the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we reviewed a range of the records related to the running of the home. These included staff files which contained staff recruitment, training and supervision records. Also, medicine records, complaints, accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

We reviewed six people’s care plans and associated risk assessments along with other relevant documentation to support our findings. We ‘pathway tracked’ people living at the home. This is when we look at a person’s care documentation in detail and obtain information about their care and support needs at the service. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection we spoke with 11 people, three people’s visitors to seek their views and experiences of the services provided at Grosvenor House. We also spoke with the registered manager, their deputy and 12 staff. In addition we spoke with two visiting health care professionals. We observed the care which was delivered in communal areas to get a view of the care and support provided including the lunchtime meal.

Updated 4 October 2017

We last inspected this service in July 2016 where we found a breach in Regulations 9, 12, 15, 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider submitted an action plan identifying how and when they would make the improvements. As a result we undertook this inspection on the 4 and 5 September 2017 to follow up on whether the required actions had been taken. We found improvements had been made and the provider was no longer in breach of Regulation.

Grosvenor House provides accommodation and care for up to 33 people, respite care is also offered. On the day of our inspection 27 older people were living at the home. The service provided care and support to older people living with diabetes, sensory impairment, risk of falls and long term healthcare needs.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

Despite improvements in multiple areas related to leadership we found the provider had not fully considered risks associated with completing formal background checks on staff who had been employed for extended periods. The registered manager sent us an action plan following our inspection identifying how they would address this oversight.

People appeared happy and relaxed with staff. There were sufficient staff to support them. When new staff were recruited, their employment history was checked, references obtained and comprehensive induction completed. Staff were knowledgeable and trained in safeguarding and knew what action they should take if they suspected abuse was taking place. Appropriate training was provided to ensure staff were confident to meet people’s needs.

It was clear staff and the registered manager had spent time with people, getting to know them, gaining an understanding of their personal history and building rapport with them. People were provided with a choice of healthy food and drink ensuring their nutritional needs were met as well as catering for individual choice and preferences.

People’s needs had been assessed and comprehensive care plans developed. Care plans contained risk assessments for a wide range of daily living needs. For example, nutrition, falls, and skin pressure areas. People received the care they required, and staff were knowledgeable on people’s individual needs. Care was provided with kindness and compassion. Staff members were responsive to people’s changing needs. People’s health and wellbeing was monitored and the provider regularly liaised with a range of healthcare professionals for advice and guidance.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

Where people lacked the mental capacity to make specific decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA). Where appropriate ‘best interest’ meetings had been instigated and outcomes recorded.

People were provided with opportunities to take part in activities ‘in-house’ and to access the local and wider community. People were supported to take an active role in decision making regarding their own daily routines and the general flow of their home.

Staff had a clear understanding of the vision and philosophy of the home and they spoke positively about their work and the management. The registered manager undertook regular quality assurance reviews to monitor the standard of the service and drive improvement.