Grosvenor Hall Care Home

We found the following examples of good practice.

The provider had been proactive in developing a plan to address any shortfall in the availability of nursing staff, consulting with CQC and other organisations as required.

The provider told us there was a very strong team spirit amongst staff. This had ensured people continued to receive safe care and support throughout the pandemic and during a recent COVID-19 outbreak in the home.

The provider had developed effective systems to ensure compliance in areas including COVID-19 testing and visiting arrangements.

Grosvenor Hall is a residential care home providing personal and nursing care to 36 people aged 65 and over at the time of the inspection. The care home can accommodate 40 people in a single building.

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

Staff had access to personal protective equipment (PPE) and followed national guidance around putting on and removing (donning and doffing) PPE. Staff were wearing PPE according to national guidance.

The home was clean, and an infection control policy was in place. Quality monitoring arrangements were in place.

Medicines were administered and managed safely. Medicine guidance for ‘as required’ medicines (PRN) was in place.

There were enough staff to meet people’s care needs. Staff had received training for their roles. New staff were recruited safely.

The risks to people’s care were assessed and measures were in place to mitigate these risks. People were cared for safely.

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.

Staff knew how to keep people safe from abuse and were confident to raise concerns with the registered manager or external agencies. When required, notifications had been completed to inform us of events and incidents.

People and their relatives knew how to raise a complaint and would feel confident to do so if needed.

People had access to a range of professional support and working arrangements were in place with healthcare professionals.

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 good (published 8 January 2018 ).

Why we inspected

We received concerns in relation to skin care and lack of transfer information on admission to hospital. As a result, we undertook a focussed inspection to review the key questions of safe, caring and well-led only.

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.

The overall rating for the service has remained good. 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 coronavirus and other infection outbreaks effectively.

Follow Up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Grosvenor Hall 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. Grosvenor Hall provides care for older people including people who are living with dementia. It provides accommodation for up to 40 people who require personal and nursing care. At the time of our inspection there were 31people living at the home.

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.

On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe.

Medicines were administered to people safely. However the provider did not have systems in place to ensure the safe management of medicines and consistent recording of medicine administration.

We saw that staff obtained people’s consent before providing care to them. Where people could not consent, assessments to ensure decisions were made in people’s best interest had been completed. However it was not always clear what decision the best interests referred to.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. Arrangements were in place to facilitate working relationships with other professionals and care providers. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There was sufficient staff available to meet people’s needs. Staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support. People were treated with dignity and respect.

Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place. A process for supervision was in place. People were provided access to social activities. Relatives felt welcomed and people were supported to maintain relationships that were important to them.

The environment was clean and some adaptations had been made in order to meet people’s specific needs. Arrangements were in place to protect people against the risk of infection.

People and their relatives knew who the registered manager and the provider were. The registered manager and provider created an open culture and people, staff and their relatives said they understood the needs of the service.

Staff felt listened to and able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Audits were carried out and action plans put in place to address any issues which were identified.

Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

There was not a registered manager in post. An application for registered manager was in progress. 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.

On the day of our inspection people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff knew how to safeguard people from abuse. The provider had systems and processes in place to keep people safe.

Medicines were administered as they were prescribed. Medication administration sheets (MARS) were not always fully completed. Guidance was not in place for as required (PRN) medicines.

The provider did not act consistently in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Best interests decisions did not detail what decisions people required support with. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. Risk assessments were completed in the residential home. People had access to healthcare professionals such as the GP and also specialist professionals. People had their nutritional needs assessed. People were not consistently supported to eat enough to keep them healthy. It was not easy for people to make choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There was not always sufficient staff to respond in a timely manner to people. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered. Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place. Staff had received regular supervision.

We saw that staff obtained people’s consent before providing care to them. People were provided with access to activities and leisure pursuits.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Audits were carried out and action plans were in place to address any issues which were identified. Accidents and incidents were recorded and managed to help prevent them happening again . The provider had informed us of incidents as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.