Archived: Granvue

Updated 13 December 2018

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 was 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.

This unannounced inspection took place on 30 October 2018 and 1 November 2018. One adult social care inspector carried out the inspection. Prior to the inspection, we reviewed information held by us about the service. This included previous inspection reports and notifications we had received. A notification is information about important events, which the service is required to tell us about by law. The provider completed a Provider Information Return (PIR). This is a form that asks 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 met and spoke with two of three people living at the service, two members of staff, and the nominated individual who is also the Chief Executive. A nominated individual is the provider’s representative and responsible for supervising the management of the regulated activity provided. We asked the local authority who commissions the service for their views on the care and support provided.

To help us assess and understand how people's care needs were being met, we reviewed three people’s care records. We also reviewed a number of records relating to the running of the service. These included staff recruitment and training records, medicine records and records associated with the provider's quality assurance systems.

Updated 13 December 2018

This unannounced inspection took place on 30 October and 1 November 2018. Granvue is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service does not provide nursing care.

Granvue offers short stay care and support for up to eight people with mental health needs who may require a short-planned admission. Granvue allocated three of these beds for people who were in need of urgent mental health crisis care; these were for people who were referred to the service through the local NHS crisis team. At the time of the inspection there were three people living at the service.

Granvue was previously inspected in December 2017, when the service was rated as ‘requires improvement’ overall. Following that inspection, the provider sent us a plan describing the actions they had taken to improve. At this inspection, in November 2018, we found improvements had been made in relation to services risk management systems, such as those associated with people's complex mental health, staff recruitment, training and the service’s quality assurance systems. However, we found improvements were still needed.

We looked at the service’s quality assurance and governance systems and found where monitoring arrangements had previously failed, improvements had been made. However, whilst some systems were working well, others were still not being used effectively or undertaken robustly enough to identify the issues seen at this inspection. For example, whilst some premises checks had been completed there was no evidence to show that any action had been taken as a result or that the information was being reviewed.

Granvue had a registered manager who, at the time of the inspection was taking a period of leave. An interim manager had been appointed by the provider and the nominated individual was overseeing the service in the registered managers’ absence. 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. Staff told us they felt supported by the new appointed manager.

People’s medicines were not always stored or managed safely. We found the service did not have a robust system in place to ensure that people or unauthorised staff could not access people’s medicines. Although the service had clear procedures in place for recording what medicine had been received or given to a person. We found staff were not always following these procedures as records were not consistently completed.

People were encouraged to make choices and were involved in the care and support they received. Staff displayed a good understanding of the principles of the Mental Capacity Act 2005 (MCA). However, we found that some systems and processes did not support the management of the home in protecting people’s rights. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). At the time of the inspection we found people could come and go as pleased. However, staff did not fully recognise that the provider had implemented a policy which meant some aspects of people's care had become potentially restrictive. We discussed what we found with the nominated individual and when we returned on the second day of our inspection we found the policy had been withdrawn and the checks had stopped.

People received a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm and protect people from any type of discrimination. Risks had been appropriately assessed and staff had been provided with information on how to support people safely. There were enough staff to meet people's needs and checks were carried out on staff before they started work to assess their suitability.

People’s health and wellbeing was promoted and protected as the home recognised the importance of seeking advice from community health and social care professionals. People were supported to eat a healthy balanced diet. Staff were knowledgeable about how to provide effective care and support.

The home was clean and people were protected from the risk of cross contamination and the spread of infection. Staff had access to personal protective equipment (PPE) and received training in infection control. Equipment used within the service was regularly serviced to help ensure it remained safe to use.

People and staff told us they were encouraged to share their views and spoke positively about the

leadership of the service. People were aware of how to make a complaint and felt able to raise concerns if something was not right.

The nominated individual was aware of their responsibilities in ensuring the Care Quality Commission (CQC) and other agencies were made aware of incidents, which affected the safety and welfare of people who used the home.

We found breaches 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.