This inspection was unannounced and took place on 21and 23 October 2015. The last inspection of the home was carried out on 30 March 2015 following a previous inspection in October 2014 where breaches of regulations had been identified. People had not been protected against the risk of unsafe or inappropriate care and treatment arising from a lack of proper information about them because records did not contain appropriate information. People were not protected because there was not an effective system to monitor the quality of service and identify and manage risk. No concerns were identified in the follow up inspection in March 2015. The provider had taken action to make improvements and legal requirements had been me. However the ratings remained the same until sustainability of improvements were found.
Grovelands is a purpose built home providing accommodation and personal care for up to 60 people. At the time of the inspection there were 50 people living at the home. The home is divided into two main parts. Residential care is on one side and specialist residential care (SRC) is provided on the other side of the home. SRC provides care for people living with dementia.
There was a registered manager 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 2008 and associated Regulations about how the service is run.
There was a homely feel to the home with staff finding time to sit and chat with people. Everyone we spoke with complimented and praised the staff who supported them. We observed people were cared for compassionately and with respect. One person told us “They [the staff] are all wonderful”.
The registered manager and deputy manager provided effective leadership and had a clear vision and purpose for the development of the home and staff team. People told us that many changes had taken place under the new management team and that they felt safe and happy living at the home. Regular resident’s and relatives’ meetings ensured people were involved in the running of the home.
People were cared for by an established, motivated and well trained staff team. Staff received regular supervisions and training that provided them with the skills and knowledge to meet people’s needs effectively. Staff worked well together and communicated well with each other. One member of staff informed us “ Staffing levels most of the time are ok, we can always talk to the manager and deputy if we are not happy, we have agency care staff to back us, but new staff are starting so that will be better”. Staff told us they enjoyed working at the home and felt supported by the registered manager and deputy manager. Staff were seen to work well as a team and showed knowledge of the people they were supporting.
Staff were very visible and attentive, noticing when those who could not verbally ask for assistance required help. They responded to people with an understanding about their likes and dislikes, they communicated gently with people, coaxing where needed. One member of staff said. “I love working here”. Another member of staff said. “We have a great manager, we all work well together”.
People’s rights were protected, Where people lacked the capacity to consent to decisions about their care and treatment, staff consulted with health and social care professionals and people who knew the person well. This helped to ensure any decisions were fully considered before being agreed to be in the person’s best interests. One member of staff said “it is about respecting choice but also helping someone who may not realise the consequence of their decisions”.
Professionals were involved where additional support was needed. One professional informed us” I am always kept informed if there are any concerns. I come in most days, my instructions are always followed straight away, and it’s a very proactive staff team”.
Care records were detailed, personalised, up to date, and accurately reflected people’s care and support needs. The care plans included information about peoples’ likes, interests and background, and provided staff with sufficient information to enable them to provide care effectively. A computer system was in place to support the recording and monitoring of care records.
People received their medicines safely. People were seen to be gently coaxed to take their medicines with explanations given on why they were taking them. People’s health needs were supported, people had access to their own GP, chiropodist and Dentist. The manager informed us that it was important that people were treated as individuals rather than having one health professional for all.
There were new systems in place that ensured the home looked homely and clean, regular spot checks were carried out by the housekeeper and registered manager to ensure standards were maintained. There was a nice atmosphere in the home, people were seen to be well cared for. One person told us” I have a nice staff member that looks after me personally. My visitors are always made welcome by all the staff, my bedroom is personal to me and people always respect my privacy by knocking and asking if they can come in, I would rather be in my own home but I can’t. So this is now my home and I don’t think I could find a better home”.
Quality assurance systems ensured the registered manager identified good practice and completed regular quality assurance checks of the home.