Grove Park

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The overall rating for this key question is requires improvement. People’s needs were now being assessed prior to them living at the service, however, the provider had not always considered staff knowledge and skills to support those with complex needs during the admission process. This increased the risk of shortfalls in the quality of people’s care and treatment. Shortfalls and concerns about people’s care had not always been identified and when this had occurred there was insufficient action taken to ensure people received effective support to meet their needs. Clinical oversight and governance processes to ensure people received care and treatment that met their assessed needs were not always effective which resulted in a breach of regulation, good governance. Staff did not always respect people’s wishes and right to decline care. However, staff generally worked in line with the 5 principles of the Mental Capacity Act 2005. People were asked consent for all support interactions. People and/or their legal representatives were asked to read and sign consent forms to enable staff to offer support. People experienced good outcomes of care by receiving joined up care from staff and health and social care professionals. Professional advice was included and updated in people care records; staff followed the advice, monitored the effectiveness, and provided feedback to professionals. You can find more details of our concerns in the evidence category findings below.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were not always assessed in line with current guidance, as some of the language used was not always person centred. Person centred language is about always respecting the dignity, worth, unique qualities and strengths of every individual this was not always apparent in care plans. Whilst the provider had implemented an online care plan system there were remaining shortfalls in available information. Care plans lacked personalised detail, contained limited background information and did not always include personal preferences. For example, care plans lacked information about what to do or how best to support a person if they declined personal care. People and their relatives provided mixed feedback about involvement in reviews of their needs. One person told us, “I don’t think I should be here, there are lots of people with dementia here and I haven't got dementia.” The provider told us some people had a recent review of their needs and along with health and social care professionals they were involved in managing safe discharge plans. Staff generally told us how care management had improved, one told us, “We are getting more information about the residents. Care plans are updated more frequently. Information is given during the handover. It's better than before.” People and relatives were consistently positive about the availability of a variety of activities which supported people’s wellbeing needs. One person told us, “The [activity person] is good, we are having a farmers market we have been making things”. And a relative confirmed, “Best thing is the activities – [Activity person] is great and now there is far more to do. Summer house is used a lot for things”.

People’s health risks were not always fully assessed by staff using nationally recognised tools. For example, The Abbey Pain Scale was used to record how a person communicated when they experienced pain. Staff had not always considered when a person was unable to describe pain what alternative signs they needed to monitor, such as body language, facial expressions and changes in behaviour. A relative expressed concern with how well staff knew people, they told us, “I'm not sure if [staff] all know [loved one] well, they need a lot of time in the morning and can get agitated in the afternoon. I think some of the staff are loud and try and jolly them along, but [person] needs time and space in the mornings”. The lack of detailed information increased the risk of people not being supported with what was important and mattered to them.

People received relevant support from health and social care professionals. For example, one person told us how staff and external professionals were working together to support them to maximise their mobility. Visiting health care professionals gave positive feedback about how staff and management have listened to suggestions and improved people’s experiences. The manager and staff continued to work with commissioners to review people’s needs and now had effective systems in place to support communication and information sharing.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People continued to not always supported to achieve positive outcomes. Whilst there had been areas of improvement, which included increased interaction and activity opportunities, people did not always receive support in line with their assessed need and choices. For example, a person’s specific support need around their choice to not shower had not always been followed by staff this resulted in the person becoming distressed. The manager recognised the need to improve the experience for people living with dementia and was engaging with health and social care professionals.

Generally, people were supported by staff who now understood people’s rights around consent. However, some records relating to care lacked guidance for staff about strategies to deploy when a person chose to decline support. This increased the potential risk of people’s choices not always being respected. Staff had now completed Mental Capacity Assessments (MCAs) which assessed whether the person had capacity to make and understand decisions. Best Interest decisions were now being completed with people and those important to them. People and families told us they were now involved in assessments. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider’s processes and working practices now ensured an adequate level of scrutiny and oversight to ensure people were protected from the risk of harm, abuse and improper treatment.