Grimston Court

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified 1 breach of the legal regulations under the well-led key question. Quality assurance systems were not robust or consistently used to drive improvement at the home. Issues we found at this inspection had not been identified or effectively addressed by the provider’s own systems. Processes, procedures and opportunities to learn from incidents needed further work. Managers told us they had identified a change of culture was needed and how they were working towards a number of improvements across the home, however there was no clear plan on how this was being actioned. Staff and family members spoke positively about the changes in management and improvements made over the past 6 months. We identified a breach in relation to good governance.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since a change of management in October 2023 leaders have been focusing on a change in culture encouraging staff to raise concerns if they had them. There was a strong focus on staff training and building relationships with families and other health professional, actively seeking feedback. Staff told us there had been improvements since the change in management and the home was a better place to work.

The home had introduced QR codes for visitors to scan and provide feedback which included family, friends, and professionals. Meetings had been scheduled with both residents and family members with attendance varying. Additional training had also been provided to upskill staff.

Staff spoke positively about the new manager and said they felt well supported in their role. They told us the manager was approachable and listened to them. The manager told us about the areas of improvement planned within the service. However, the short time they had been in post for at the time of inspection, meant these had not yet been actioned. They were well supported by the operations manager who had been in the service since October 2023.

Processes and policies were not always followed and implemented by managers and leaders which had led to compliance issues on this inspection. Throughout the inspection we observed people living at the service engaging with the management team and there appeared to be a good rapport with people. Both the manager, deputy and administrator were relatively new to their positions and so they were not always fully aware of the issues within the service. However, they were passionate about improving the service. The manager told us they were in the process of registering with CQC.

Staff we spoke with knew the process around speaking up and were confident that if they needed to raised concerns they would be acted upon. Staff told us the new manager was approachable and they could also go to the operations manager. Leaders had been proactive in encouraging staff to share their experiences and concerns as part of their drive to improve the culture of the service.

The service had a whistleblowing policy in place. Leaders had regular 1:1’s with staff to understand if they had any concerns and whether they were aware of how to raise concerns. There was also HR drop-in sessions held at the home for staff to attend so they could ask any questions they might have or raise concerns.

Staff told us they were treated well by the managers and leaders, and they had not faced discrimination at work. People told us how they were provided with free accommodation at the service, so they didn’t have to travel long distances between staff and that this had helped with their well-being. Staff told us they felt well supported and listened to by the new managers.

The provider had a number of initiatives and schemes to support staff well-being and to recognise and reward staff’s hard work. Support and resources were also available to staff around their mental, emotional, financial, and physical well-being by way of drop-in sessions and awareness days. Managers regularly spoke to staff and asked them if they had any concerns or were experiencing any kind of discrimination.

Managers did not provide assurance that governance processes were robust and there was a lack of evidence around how improvements were being prioritised and driven forward. At the time of the inspection the manager was not yet fully aware of providers systems and processes in place and how to access information on the multiple electronic systems. The operations manager told us they were continuing to support the manager with this area of their development. Further work and support were needed in the service to look at processes that were in place and their effectiveness.

New systems the service had introduced for recording accident and incidents and safeguarding concerns allowed remote oversight from senior management at provider level, however these had not identified where duty of candour had not been fulfilled. Audits were not effective and had not highlighted concerns found on inspection. Provider visits had not been regularly completed as the operations manager was working in the service, it was therefore not clear how the provider had an objective view of safety and compliance within the home. Processes in place such as medication competencies had not been used as intended. Staff had been signed off as competent despite not completing the required training or reading the relevant policies. Regular health and safety checks on equipment were not always carried out as required when staff were on leave, which posed a potential risk. The provider did not always store records and confidential information securely. They had not always kept accurate and contemporaneous records in relation to the care of people. The provider did not demonstrate by way of records or meeting minutes that they had good oversight of the service. We identified a breach of regulation in relation to good governance.

The service worked with other organisations and people had access to health professionals. People told us how they had trips to the local garden centre which they enjoyed, although it was not clear how those less able accessed the community.

Leaders told us how they had been working with the local authority to identify and act on concerns and improve the service. Staff had a good understanding of other partner agencies that supported the residents in the service and the reasons for their input. Leaders told us that due to the recent vacancy in the activity’s coordinator post the activities offered were not as varied as previously. However, they had recently filled that position and as a temporary measure staff were running activities in the home.

Partners and visiting professionals had noticed a positive change in the service over the last 6 months and felt they had a good working relationship with the home. There were no concerns raised and they said they were confident in the operations manager and home manager in actioning any issues identified.

We saw how referrals had been made to other professionals as needed such as the community mental health team and GPs. However, the relevant people had not been consulted around some medication issues identified as part of the inspection. Following feedback, the manager consulted the pharmacist for advice. Advice from professionals was available in the persons care records however, we saw that this was not dated and not factored into the care plan to guide staff.

Managers had changed the way they engaged with staff and professionals as they identified this as an area for improvement under the last manager. They had also reviewed staff training and management of staff following learning from incidents. However, further learning and improvement was needed in relation to the environment, processes, and oversight. Managers knew there was more work to be done in the home to improve further and they were responsive to feedback both from professionals and as part of the inspection.

The service did not always follow best practice. Learning from incidents was not always sufficient in addressing risk to people. Due to the amount of change within the service over the past 6 month, we recognised the service needed more time to improve and embed learning. The service had introduced QR codes to encourage visitors and professionals to provide feedback, although we did not see the outcome of the feedback and a bespoke software system had been developed for the provider to allow for incident analysis. Work was on-going to further develop the software introduced.