The Grove

Updated 1 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 inspection took place on 13 June 2018 and was unannounced. The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we looked at the information we already held about the service. This included details of its registration, previous inspection reports and any notifications the provider had sent us. We contacted the local authority with responsibility for commissioning care from the service to gain their views. Prior to the inspection 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 spoke with four people that used the service. We also spoke with five members of staff that included the registered manager, the deputy manager two support workers and the cleaner. We spoke with one healthcare professional who was visiting the service during the course of our inspection. We observed how staff interacted with people that used the service and we examined various documentation. This included three sets of records relating to people that used the service including their care plans and risk assessments. We looked at medicine records and financial records for people. We examined staff recruitment, training and supervision records for three staff that worked at the service, minutes of residents and staff meetings and staff and residents’ surveys and various policies and procedures.

Updated 1 August 2018

We last inspected this service in January 2016 where it was rated ‘good’ overall, with one breach of the regulations because medicines were not managed safely. This inspection took place on 13 June 2018 and was unannounced. At this inspection, we found that medicines were being managed safely and that the service was now rated ‘Outstanding’.

The service is registered to provide accommodation and support with personal care for up to eight adults with mental health needs. Seven people were using the service at the time of inspection.

There was a registered manager in post. 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.

The service was exceptionally responsive and used innovative ways to ensure that it was providing care that was tailored to meet people’s needs. Staff and management went the extra mile to include people in all aspects of their care as well as creating opportunities for them to socialise and integrate within the community. Arrangements were made to support people in maintaining relationships so that they could live as full a life as possible.

People’s hobbies and interests were championed by the service and staff made sure people were taking part in activities they were passionate about. The service was actively involved with the local community in ensuring resources and networks were utilised to benefit people who used the service, as well as in the local area.

The service was particularly skilled at helping people explore and record their wishes about care at the end of their life and plan how these wishes would be met. The service was very responsive in enabling people to have a comfortable and dignified death.

Visiting professionals spoke positively about the service and had confidence that the care provided was person centred.

The service was remarkably well led and staff felt extremely proud to work there. Staff had a strong organisational commitment to the service and felt motivated. The registered manager had a clear vision and strategy to deliver high-quality care and support and to promote a positive culture that was person-centred, inclusive and empowering.

The service was innovative and had developed a community group for people with mental health needs, to benefit people who used the service and others in the wider community.

The service was safe and people were protected from harm. Support workers were knowledgeable about safeguarding adults from abuse and what to do if they had any concerns and how to report them. Safeguarding training was given to all staff.

Risk assessments were thorough and personalised. Support workers knew what to do in an emergency situation.

Staffing levels were meeting the needs of the people who used the service and support workers demonstrated they had the relevant knowledge to support people with their care.

Recruitment practices were safe and records confirmed this.

Training for support workers was provided on a regular basis and updated when relevant. Support workers told us the quality of training was good.

Support workers demonstrated an understanding of the Mental Capacity Act (2005) and how they obtained consent on a daily basis. Consent was recorded in people's care plans.

People were supported with maintaining a balanced diet and the people who used the service chose their meals and these were provided in line with their preferences.

People were supported to have access to healthcare services and receive on-going support. Referrals to healthcare professionals were made appropriately and a multi-disciplinary approach was adopted to support people.

Positive relationships were formed between support workers and the people who used the service and staff demonstrated how they knew the people they cared for well. People who used the service told us support workers were caring and treated them with respect.

Care plans were detailed and contained relevant information about people who used the service and their needs such as their preferences and communication needs.

Concerns and complaints were listened to and records confirmed this.

Quality assurance practices were robust and taking place regularly.