We inspected Grosvenor House on the 20 and 22 April 2015. Grosvenor House provides accommodation and care for up to 33 people, respite care is also offered. On the day of our inspection 21 older people were living at the home. People had various long term health care needs including diabetes. Other conditions impacted on people’s mobility putting people at risk from falls. People also had sensory impairments that impacted including poor sight and hearing.
A registered manager was in post. 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 and associated Regulations about how the service is run.
Throughout our inspection, people spoke highly of the home. Comments included, “Really lovely place to live” and, Very happy with the home.” However, we identified a number of areas that required improvement. Although audits had been completed these did not identify all areas that needed action.
We found some peoples care plans did not always provide staff with sufficient information to provide effective care. Areas we identified requiring improvements within care planning documentation included diabetes and continence management.
The recording of people’s prescribed creams was inconsistent and requires improvement however all other areas associated with medicines were managed safely and in accordance with current regulations and guidance.
We found some people who had lived at Grosvenor House for six months or less had not had all sections of their care plans completed. We identified gaps in several areas. However most people’s care plans provided detailed guidance for staff on how to meet people’s needs.
The Provider and registered manager had quality assurance systems in place however these did not always provide the registered manager with full oversight of the service. Some actions identified via audits had not been actioned. Accidents and incidents were recorded appropriately however the actions and outcomes from these were not used as a learning opportunity for staff.
People felt safe living at Grosvenor House. Training schedules confirmed staff members had received training in safeguarding adults at risk. Staff knew how to identify if people were at risk of abuse or harm and knew what to do to ensure they were protected.
People were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
The provider had good retention of staff, with some staff members having worked there for over five years. Throughout the inspection, people spoke highly of the home. Comments included, “They are wonderful here.” “They couldn’t be better, they are all very caring.” It was clear staff had spent considerable time with people, getting to know them, gaining an understanding of their personal history and building friendships with them. People were provided with a choice of healthy food and drink ensuring their nutritional needs were met.
Staff understood the needs of people and care was provided with kindness and compassion. People spoke highly of the care they received and confirmed they received care in a timely manner. Staff members were responsive to people’s changing needs. People’s health and wellbeing was continually monitored and the provider regularly liaised with healthcare professionals for advice and guidance.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.
The registered manager had created a service with a friendly and relaxed atmosphere. It was clear they took pride in the running of the home. Staff had a clear understanding of the vision and philosophy of the home and they spoke enthusiastically about working at Grosvenor House.
We found a breach in a Regulation. You can see what action we told the provider to take at the back of the full version of this report.