Archived: Grey Ferrers Care Home

Updated 25 February 2022

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.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 1 February 2022 and was announced. We gave the service 18hours’ notice of the inspection.

Updated 25 February 2022

Grey Ferrers Care Home can accommodate up to 120 people across four separate units, each of which has separate adapted facilities. One of the four units provides palliative and end of live care and the other three units specialises in providing care to people living with dementia, mental health needs and physical disabilities.

At the time of our inspection one of the units providing care to people living with dementia, mental health needs and physical disabilities was not in use. There were 70 people using the service when we visited.

People’s experience of using this service and what we found

The management of people’s medicines needed to be strengthened to ensure people received their medication safely. We found some areas of medication administration did not follow best practice.

We found staffing to be mostly adequate in two units. However, in the third unit staff told us their ability to provide timely and good quality care was impacted because there were not being enough staff. We noted some people were still getting up at 11am. Across all units we found that some people had to wait a long time for their meals because of a lack of staff to support them

We have made a recommendation about safe staffing levels.

Detailed risk assessments were in place and reviewed regularly to reduce potential risks to people. However, the guidance in these was not consistently followed by staff. People’s needs were assessed and documented. However, we found staff had not always completed care monitoring records for personal and oral care.

Overall, the service was clean and hygienic. Staff followed infection control and COVID-19 guidance and wore appropriate Personal Protective Equipment (PPE). However, we found some areas of the environment required improvement to ensure they were easy cleanable and to keep people safe from the spread of infection.

People’s oral healthcare needs were not always met because staff did not always follow the guidance in their care plans.

We have made a recommendation about the management of people’s oral health care needs.

Overall, the service was suitable and accessible to the people living there. However, there were some areas that required attention. Many of the areas looked tired and shabby and in need of redecoration.

There was an extensive range of quality checks in place to monitor the quality of the service. However, these needed to be strengthened to ensure they identified areas where improvement was needed. We found there was a task focused culture among some staff. We saw some staff interactions with people lacked a person-centred approach.

People and their relatives felt that Grey Ferrers was a safe place to live. Staff we spoke with had completed training in safeguarding people who use care services from potential harm and understood how to recognise abuse.

Staff received an induction when they first commenced work at the service and ongoing training that enabled them to have the skills and knowledge to provide effective care. Most staff felt well supported by the management team. They received regular supervision and said they could contact the registered manager if they needed support.

People were supported to eat and drink enough to maintain their health and well-being. Staff supported people to live healthier lives and access healthcare services.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager had taken up their role in January 2021. The registered manager and area director manager had identified that further development was needed and had implemented numerous improvements. They were in the process of developing an action plan detailing their priorities to bring about change.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (published 02 July 2019). The service remains rated Requires Improvement following this inspection. This service has been rated Requires Improvement for the last three consecutive inspections. This demonstrates a lack of sustained improvement by the provider.

Why we inspected

The inspection was prompted due to whistle-blowing concerns received about staffing levels, a lack of choice at mealtimes, inadequate meals provided to meet people’s dietary needs and the management and leadership of the service. A decision was made for us to inspect and examine these risks. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence the provider needs to make improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Grey Ferrers Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a breach in relation to the safe administration of medicines and risk management and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.