Griffin 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.
Griffin Lodge provides accommodation and personal care support to adults with a range of complex and challenging needs arising from their learning disabilities, sensory impairments and physical and mental health needs. The accommodation is purpose built and made up of two connected bungalows, which provide 12 en-suite bedrooms and a range of communal and activity areas. The home has a large outdoor area at the rear for leisure and activities. The service is located in the Heald Green area of Stockport. Griffin Lodge is part of a large organisation; Community Integrated Care. The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At the time of our inspection there were 12 people living at Griffin Lodge.
This inspection was carried out over three days between 23 and 25 April 2018. Our initial visit on 23 April was unannounced.
We last inspected Griffin Lodge in March 2016. At that inspection we rated the service as good in the safe and responsive domains, and requires improvement in effective, caring and well-led. The overall rating for the service was requires improvement. At that inspection we found one regulatory breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This previous breach related to consent to care in line with the Mental Capacity Act 2005 as best interests decisions were not always in place. As a result of this breach we issued a requirement notice to the registered provider and they supplied us with an action plan.
The service did not have a registered manager in place. The registered manager had left the service three weeks previously and the deputy manager was currently holding the position until the new home manager started in their post. A registered manager is a person who has registered with the Care Quality Commission (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.
At this inspection we identified breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were around a lack of training and induction, infection control concerns and management oversight. You can see what action we told the provider to take at the back of the full version of the report. We also made two recommendations in the report regarding the recording of aspirational outcomes for people and using appropriate language during support
We found Griffin Lodge had a high level of staff vacancies and used a significant percentage of agency staff. Staff and visitors told us they had concerns around the number of agency staff used and the current staffing levels.
Training for staff was not up to date. We found staff had recently been recruited and were supporting people before completing their mandatory training or induction programme.
We identified concerns regarding infection control practice within the home and a recent infection control audit had identified the home required a deep clean. The home did not employ a cleaner and staff were required to undertake cleaning tasks.
Care files we looked at showed plans and risk assessments documenting people’s specific care and support needs. These were plans outlining how people needed to be cared for in an effective and safe way. However, these did not always include information around people’s family or history.
There were systems and checks in place to monitor the quality of the service to ensure people received safe and effective care. However, these checks had failed to address the concerns we found during our inspection. In addition, we found that previously reported actions regarding fire safety had not always been followed up.
Family and professional visitors to the service spoke highly of Griffin Lodge. One family member told us, “Staff are caring; they take a genuine interest in people – it’s more than just a job.”
The staff files we looked at showed us that safe and appropriate recruitment and selection practices had been completed by management to satisfy themselves that suitable staff had been employed to care for vulnerable people.
Care records at the home showed us that people received input from health care professionals, such as psychiatry and social care workers. People were supported to visit the dentist and general practitioner.
We looked at the safe management and administration of medicines and found medication was managed and administered safely.
People’s current care needs were effectively communicated through a system of team meetings, handover meetings and communication books. Information was communicated in different formats to enable people to understand. Staff were required to learn British Sign Language to ensure people and staff could communicate effectively together.
Responsive action was promptly taken to address changes in people’s specific care needs.
The home has good links with partnership agencies and the community. People accessed the community on a daily basis and had a comprehensive programme of personalised activities in place.
The service had completed statutory notifications to CQC of any accidents, Deprivation of Liberty Safeguards DoLS, serious incidents, and safeguarding allegations as they are required to do.
There was a complaints policy in place and we saw information displayed on how to make a complaint.
Staff told us they felt supported in their role and were complimentary regarding the acting home manager.
Information was provided for people in a range of formats to cater for individual care and communication needs.