• Care Home
  • Care home

Archived: Grove House

Overall: Requires improvement read more about inspection ratings

1 Palm Grove, Claughton, Wirral, Merseyside, CH43 1TE (0151) 652 8078

Provided and run by:
Four Seasons (Emmanuel Christian Care Home) Limited

Important: The provider of this service changed. See new profile

All Inspections

02/12/2014

During a routine inspection

We visited the home on 02 December 2014. The home is currently registered to accommodate up to 63 people. At the time of our inspection there were 43 people living in the home. The home’s accommodation is over three floors. A further floor at the top of the building was for staff training and other staff uses.

The ground floor was for younger physically disabled people, the middle floor was for people needing general residential and nursing care, and the top floor was for people with dementia type conditions, who also had nursing needs.

This inspection was to follow up on our previous one in July 2014, where we had found that the home was in breach of several of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We had asked the home to make improvements. The home had sent us an action plan and updated us regularly, to record improvements. The action plan advised us that all the identified areas would be improved by 14 November 2014.

The home required 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. At our previous inspection there had been a manager, but they were not registered. They left the post shortly after that inspection. At the time of this inspection, a new manager was in post who had not yet registered with CQC. He was supported by a registered manager and a regional manager.

We found that the home had made progress and had made improvements, but still required further improvement before it could be rated as a good service.

People told us that they felt safe and happy at the home. Recruitment practice followed guidelines and we saw that there were sufficient staff on duty, however some training was needed for some staff. People told us that ‘things were improving’ since the new manager had been in post.

People told us that they were well looked after, but we were concerned about consent being obtained prior to care being given.

21, 22, 25 July 2014

During a routine inspection

The inspection team who carried out this inspection consisted of three inspectors, one of which was a pharmacist. We visited on 21 and 22 July 2014 and had a meeting with the provider on 25 July 2014.

During the inspection, the team worked together to answer five key questions; is the service safe, effective, caring, responsive and well-led?

We spoke with seven visitors and relatives of people who lived there and with the manager, the regional manager and seven other members of staff. We also had a brief conversation with a visiting GP. We viewed the environment and observed interactions. We reviewed nine full care plans held in the Nurses station on each floor and three room files, which contained basic information and daily recordings and were situated in each person's room. The room files had charts individual to the person, such as fluid balance, food intake and repositioning charts and bed rail checks.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We determined that the service was unsafe.

Medication recording, administration and storage were found to be incorrect. This could seriously affect the health, care and treatment of people who used medicines.

Parts of the premises were found to be unsafe, particularly the garden area. This was a serious safety hazard to people venturing near the unguarded, un-level area in the garden. There were trip hazards within the building.

Safeguarding procedures had not been followed. Lessons had not been learned from errors and omissions.

However, people had been cared for by staff who were kind and demonstrated knowledge of people's needs. People's rooms were large and were clean and well cared for.

There were enough staff on duty to meet the needs of the people living at the home at the time of our inspection and a member of the management team was available on call in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation ensuring that the premises are safe, that safeguarding procedures are followed and that lessons are learned from incidents.

Is the service effective?

We found the service not to be effective.

We saw that staff had not received sufficient training to meet the needs of the people living at the home. We saw from records that staff had not had appropriate training for them to meet the needs of people in the home. Staff confirmed this during their discussions with us.

People using the service told us that they were happy with the care they received and felt their needs had been met.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to appropriately training and supporting staff to meet the needs of people they care for,

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. A relative had written, "Staff are very helpful. I go away for long periods. Peace of mind, my mum being here'.

Is the service responsive?

We found that the service was not responsive.

People's needs had been assessed before they moved into the home. Their care plans were regularly reviewed and altered as appropriate to their changing physical needs. There was little reference to their mental needs. Staff were not responsive to people's challenging behaviour or cries for help. Records did not record people's preferences, interests, or aspirations. Care and support had not been provided that met their needs. People had access to activities but were not supported to interact socially with each other.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to assessing people's needs and providing appropriate care and social activities.

Is the service well-led?

We found the service was not well-led.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

Quality assurance processes were in place. However we did not see action plans which had been made as a result of concerns found through these processes. Errors were repeated which was evidence that lessons had not been learned.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.

20 February 2014

During an inspection looking at part of the service

At our previous inspection carried out in August 2013 we found there was no registered manager in place and the provider had not ensured that there were enough suitably qualified, skilled and experienced staff on duty at all times.

At this inspection we found that a manager had been appointed and they had applied for registration with the Care Quality Commission.

We also found that the provider had ensured there were enough staff to meet people's needs.

We spoke with seven people who used the service and two relatives. All said they were happy with the care, although one person on the ground floor said that sometimes she had to wait for assistance but usually staff responded to requests promptly. Another person said "The staff are very helpful and kind, they come straight away when I ring the bell". A relative said " I know my relative is safe here and well looked after. I come at various times of the day and have never had any concerns. The staff are very patient and kind and take the time to sit and chat to people".

6 August 2013

During an inspection looking at part of the service

At our last inspection on 9 April 2013, we had identified concerns regarding the care and welfare of people who lived at the home, staffing levels and quality assurance systems.

At this inspection, we spoke with seven people who lived at the home and three relatives. All of them praised the quality of care received from the staff. Comments included: 'They are marvellous' and 'They provide excellent care'.

At our last inspection, we found that on the dementia unit, staff lacked the necessary training and understanding in order to be able to look after people in their care. At this inspection, we found staff had access to e-learning training but they still lacked confidence in their ability to look after people with dementia. Staff told us that further training had been arranged.

We found that there were still problems with staff deployment within the home. There had been a high level of staff sickness for several months which had compounded this issue. However, the home had made efforts to reduce this problem. We found that staff shortages had had some impact on people who used the service. For example, four people told us they had to wait to be assisted to the bathroom.

We found there had been some improvements in quality assurance systems in place to monitor the health and safety aspects of the home.

9 April 2013

During a routine inspection

We spoke with seven people who lived at the home and three relatives. All of the people we spoke with told us staff treated people with dignity and respect. One person told us: 'I am really pleased with the care provided.' Another said: 'It's a nice place, generally I am satisfied.' However we found that on the dementia unit, staff lacked the necessary training and understanding in order to be able to look after people in their care.

Some concerns were raised with the quality of food provided but we found the home had begun to address this by involving people in menu planning.

We found that medications were appropriately managed within the home. However some records had not been updated.

We found there were problems with staff deployment within the home. There had been a high level of staff sickness for several months which had compounded this issue and the home had used agency nursing staff . We found that staff shortages had had some impact on people who used the service. For example, two people told us they had to wait to be assisted to the bathroom and another told us that they could not get up and dressed when they wanted as the night staff did not have the time.

We found there were quality assurance systems in place to monitor the health and safety aspects of the home. However, we found that when shortfalls were identified, the necessary actions for improvements were not always taken in a timely fashion.

12 October 2012

During an inspection looking at part of the service

We previously carried out an inspection on 4 July 2012 and had concerns relating to the lack of safeguarding training and training plans in place for the staff. The provider sent us an action plan detailing how the practice was going to become compliant with the regulations.

We carried out this review on 12 October 2012 by asking the provider to send us information regarding what training had now been completed. We didn't visit the service but we undertook a desk top review as the acting manager provided us with enough information to demonstrate compliance against the regulations.

4 July 2012

During a routine inspection

We spoke with four residents and their relatives and friends. They told us staff always treated them kindly and respectfully. One resident said 'I have been spoilt here so much I don't want to go home.' Another resident described the home and support they had received as 'Marvellous.'

All the residents we spoke with felt they were safe at the home and when they had to use the emergency call bells for any reason, staff had attended to them promptly.

Three residents told us they were happy with how their medicines were given to them and that they were always given on time.

All of the residents and relatives we spoke with were very happy with the home and did not have any concerns or issues about the care received. Two of the residents told us they had made a comment about food to staff and the home had responded promptly and in writing to their concern much to the residents' satisfaction.

10 March 2011

During a routine inspection

During our visit to Grove House we were able to sit in on a residents and relatives meeting, which was very well attended. It was clear that people felt able to voice their opinions and raise subjects that were important to them. There was a lively atmosphere and the activities organiser, who ran the meeting, spoke clearly and made sure that everyone was included.

We observed many positive interactions and shows of affection between staff and people living at the home. One letter that had been received recently read ' Sincere thanks for the excellent attention T received during his stay with you. We were struck by the manner in which your operational efficiency was accompanied by the tender care of each member of the team. One facet we must mention is an occasion when a dear elderly soul, broken and in tears, was comforted with a hug and a kiss by a member of the staff.'

One person who lives at the home told us that there are no restrictions on visitors, you can have as many as you like any time.

During our visit we were able to look at written comments received from people who had recently stayed at Grove House and their families. These included:

My relative has received excellent physiotherapy.

Our relative is very well looked after, always clean and appears happy.

Your personal help charmed us all. Nothing was ever too much trouble.

Thank you so very much for making my stay at Grove House such a very happy and enjoyable one. I was always treated with such kindness by everyone and you all worked so hard to get me as well and mobile as possible and the team put in so much hard work to get me home as soon as possible.

Thank you for the care that enabled my mother to recuperate and get back home. I was particularly impressed by your attention to detail, the monitoring of her fluid intake was very reassuring, as was the nursing care with prompt action for problems.

Thank you all for the fantastic care you gave to Mum. She wouldn't have got home without you.

We spoke with people who were having lunch in one of the dining rooms. One person said she has been here for eight weeks for intermediate care and it had been 'absolutely marvellous', she had no complaints about the care she had received. Another person said he had been here four or five weeks and 'can't fault it'.

One of the people we spoke with said that she had enjoyed her lunch very much today as it was her favourite. She said that the staff are always giving her food. Another person told us that he always gets plenty to eat and can ask for more if he wants to.

During the staff meeting, one person said 'I'd like to thank all the staff, they are absolutely marvellous, especially the chefs', and a visitor said that she would also like to thank the kitchen staff as it is so important for people to get good food.

The people we spoke with said that they feel safe and secure at Grove House. We saw a recent comment made by a relative which read 'I know that my relative is very safe in your hands'.

One of the people who lives at the home told us that 'it is always spotlessly clean'.

Two of the people who we spoke with said that they always get their medicines on time and correct.

One of the people we spoke with said that his call bell is always answered quickly day or night, and another said that staff are always there when you need them.

During the residents and relatives meeting, one person said 'I think the staff are little short of miraculous', and another contributed 'I think everything is run wonderfully for all types of patients'.

The people we spoke with said that they would tell the nurse if they had any complaints. A visitor we met said that the only problem they had was clothing going missing in the laundry. One of the carers had followed up this complaint and everything has now been found and returned.

During the residents meeting, one person said that he was fed up of being woken up by someone shouting in the night and a visitor said that her relative had also mentioned being disturbed by someone noisy at night. We spoke to manager about this and she was aware of a problem with a person who wakes up early and said that night staff were addressing this as best they could.