Grove Lodge

Updated 15 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an 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 care service.

Service and service type

Grove Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Grove Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 20 February 2023 and ended on 2 March 2023. We visited the location’s service on 20 and 21 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, this included

notifications made by the service and any concerns raised with CQC. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We sought feedback from the local authority. We used all of this information to plan our inspection.

During the inspection

We visited the service on two occasions. We spoke with 10 relatives who had family members living at the service to get their views of the care provided. We spoke with and received written feedback from 10 members of staff including the registered manager, senior carers, clinical lead, care workers and auxiliary staff.

As people were living with dementia and were unable to have an informed conversation with us. Together with extensive observations over the two days, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included elements of 13 people’s care plans, medicines records, staff recruitment and training. We looked at a variety of records relating to the management of the service. We also received feedback from 2 health professionals who work with the home.

Updated 15 March 2023

About the service

Grove Lodge is a residential care home providing personal care for up to 22 people aged 65 and over. At the time of our inspection there were 17 people using the service.

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

Staff sought to support people in the least restrictive way possible and in their best interests. However, it was not always clear when people could not make their own decisions, and consent to their care, and decisions made on their behalf were made within the framework of the Mental Capacity Act 2005. Care documentation was not always completed as planned, there were gaps, which meant there was a risk people did not receive their care in a safe way.

Management oversight was not sufficiently robust. Audits were not always effective in identifying issues including those we found with mental capacity assessments, best interest decisions and the extent of gaps in care recording. There was no evidence of impact on people from these omissions however there was the potential for people to be placed at increased risk of harm.

The environment was being adapted to meet the needs of people and to improve their experience. The registered manager was planning to further develop the home environment to make it more ‘dementia friendly’. This is the term used when the environment supports people living with dementia to orientate themselves to their surroundings.

Oral assessments and care had improved since our previous inspection. People had detailed initial assessments and person-centred care plans incorporating their needs in this area of their lives.

People’s mealtime experience had improved since the last time we inspected. People appeared to enjoy the meals and relatives felt health related dietary risks were known and well managed by staff.

Relatives and staff told us there were enough staff to meet people’s needs in a safely and timely way. Our observations confirmed this.

Relatives and professionals were confident in the skills and experience of staff providing care. People had timely access to health and social care professionals and staff followed their guidance. This helped support and maintain people’s health and wellbeing.

Relatives felt the home was well run. They and staff praised the registered manager for their support and seeking their views about the care their family members received. Many staff felt the registered manager was the best manager they had worked with.

The registered manager was responsive to the feedback provided throughout our inspection.

We carried out extensive observations over the two days to understand people’s experience of living at Grove Lodge. This included their interactions with staff, other people and the home environment.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 8 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider continue to review people’s mealtime experience in line with appropriate good practice. At this inspection we found the provider had made improvements.

Why we inspected

We carried out an unannounced inspection of this service on 8 and 20 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care, need for consent and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

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.

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

We have identified breaches in relation to need for consent and good governance at this inspection.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.