Background to this inspection
Updated
14 August 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 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.
This was a comprehensive inspection that took place on 27 June 2018 and was unannounced. This inspection was carried out by an inspector.
Before the inspection we reviewed the information we held about the service including the Provider Information Return. This is information we require providers to send to us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also looked at reports from previous inspections and statutory notifications submitted by the provider. Statutory notifications contain information providers are required to send us about significant events that take place within services.
During the inspection we spoke with five people, two staff, the compliance manager and the registered manager. We reviewed five people’s care records which included needs and risk assessments, care plans, health information and support plans. We also reviewed five staff files which included pre-employment checks, training records and supervision notes. We read the provider’s quality assurance records and complaints procedure. Following the inspection, we contacted four relatives to gather their views about the service people were receiving.
Updated
14 August 2018
The inspection took place on 27 June 2018 and was unannounced.
Grennell Lodge provides nursing care, personal care and support for up to 32 older adults with mental ill health. At the time of this inspection there were 23 people living in the home. At the last inspection in December 2016, the provider was found to be meeting the regulations we inspected.
Grennell Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 did not have a registered manager. The manager was in the process of registration with the Care Quality Commission [CQC]. A registered manager is a person who has registered with the CQC 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.
People and their relatives told us they felt people were well cared and safe living at Grennell Lodge. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise risks and manage identified hazards to help keep people safe from harm or injury.
There were sufficient levels of staff to meet people’s needs. This was endorsed by people we spoke with and their relatives.
People received their medicines appropriately and staff knew how to manage medicines safely.
People had a varied and nutritious diet and choice of meals. They were supported to have a balanced diet which helped them to stay healthy.
Staff supported people to maintain health through regular monitoring by healthcare professionals.
Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and appropriate applications were made by the provider to the local authorities for those people who needed them. We saw that some of the local authorities were delayed in updating people’s assessments due to a backlog and high demand generally for this type of assessment for people. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.
Staff were kind and caring and established positive relationships with people and their families. Staff valued people, treated them with respect and promoted their rights, choice and independence.
Staff understood relatives, family and friends were important to people and ensured they were appropriately involved in people's care. People were informed and supported to access independent advocacy services if they needed someone to speak up about their care on their behalf.
People's care was personalised, inclusive and timely. Staff acted promptly when people needed assistance and they understood and communicated with people in a way that was meaningful to them.
People received support and equipment to help them to stay independent. They were often supported to participate and engage in home life and sometimes within their local community.
People and their relatives were appropriately informed and comfortable to raise concerns or to make a complaint if they needed to.
People, relatives and staff were positive in their comments about the manager. They said he promoted an open and positive working environment and they felt able to contribute positively to the development of the service.
We saw there was a wide range of quality assurance audits in place that provided valuable information to develop and improve the service. This included audits of a wide range of aspects of the service provision. Where suggestions or comments were received the manager used the information to develop and improve the service.
The provider ensured that statutory notifications were sent as required. Information was included to do with incidents that required notification to the CQC and the registered manager was clear about what was required to be reported.