Background to this inspection
Updated
23 October 2015
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 visited the service on 25 and 26 August 2015. Our inspection was unannounced and the inspection team consisted of one adult social care inspector.
During our visit to the service we spent time speaking with five people who used the service, three family members and three visitors including health professionals. We also spoke with four care staff and the registered manager.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed care and support in communal areas and staff interaction with people during a mealtime. We looked at people’s care records and also records relating to both staff and the management of the service.
Before our inspection we reviewed the information we held about the service including notifications of incidents that the provider had sent us since the last inspection, complaints and safeguarding. We also contacted local commissioners of the service, the local authority safeguarding team and Healthwatch who visited the service on 5 February 2015 to obtain their views. No concerns were raised about the service.
Updated
23 October 2015
This was an unannounced inspection, carried out on 25 and 26 August 2015.
Florence Grogan House is a residential care service over two floors, which provides accommodation and personal care for up to 40 people including 10 people living with dementia. Access to the upper floor is via a passenger lift or stairs. Local shops and other amenities are a short distance away from the service and there are good public transport links close by. At the time of our inspection there were 37 people living at the service.
The service has a registered manager. 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.
We last inspected this location in August 2013 and we found that the registered provider met all the regulations we reviewed.
At this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We found that improvements were required in how people’s care and support needs were assessed and planned. Care plans we reviewed lacked detail and were not personalised about how to meet the person’s needs.
Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Not all staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) but were able to show a basic understanding of the key principles when asked. Care plans did not identify how decisions for people who lacked capacity, were made in their best interests.
We have made a recommendation about recording decisions in line with the MCA code of practise.
People received their medication as prescribed and staff had completed competency training in the administration and management of medication. Two people’s medication administration records (MAR) had not been appropriately signed or coded when medication was given.
Systems were in place to check on the quality of the service but records we saw were not regularly completed in line with the registered providers own timescales. We were not notified as required about some incidents and events which had occurred at the service.
People were safe and staff understood what is meant by abuse and they were aware of the different types of abuse. Staff knew the process for reporting any concerns they had and for ensuring people were protected from abuse. Family members told us they had no concerns about their relative’s safety. They commented; “I know that my family member is safe and that if there are concerns they will contact me and let me know. They all treat [my relative] with respect and as if she is one of their own family members”. Staff told us they would not hesitate to raise concerns and they felt confident that they would be dealt with appropriately.
Robust recruitment processes were followed and there were sufficient qualified, skilled and experienced staff on duty to meet people’s needs.
Staff were caring and they treated people with kindness and respect. People were happy with the care that they had received. They told us that staff always treated them as individuals and were mindful of their privacy and dignity and helped them to maintain their independence. Relatives and visitors told us that they had no concerns about the care that they observed. They said they had always been made to feel welcome and they felt that the service was homely.
Staff worked well with external health and social care professionals to make sure people received the care and support they needed. People were referred onto to the appropriate service when concerns about their health or wellbeing were noted.
Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.
The premises were accessible, clean, safe and free from unpleasant odour and staff were able to describe their responsibilities for ensuring people were protected against any environmental hazards.