The Grove

Updated 21 April 2022

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 Care Act 2014.

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 one inspector.

Service and service type

The Grove is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered. However, there was a manager, in post, who was in the process of registering with CQC. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with six members of care staff, the manager and office manager. We reviewed people’s medicine records and looked at three people’s care plans.

We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including audits and staff support were reviewed.

After the inspection visit

We spoke with two visiting healthcare professionals and sought clarification on information regarding staff training and supervision from the manager and office manager.

Updated 21 April 2022

About the service

The Grove is a residential care home providing personal and nursing care for up to 38 people. At the time of the inspection the service was supporting 31 people. The service occupies a detached building with a lift to access upper floors.

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

We last inspected the service in December 2021. At that time, we noted improvements were being made by the provider. However, several recommendations were made where further improvements were required, and the rating remained requires improvement in Safe and Well led. At this inspection the service had taken action to meet the recommendations.

Visiting healthcare professionals told us they had seen recent improvements in the service provided. They told us, “They take advice and carry out any care required. We have no concerns” and “Things are definitely much better. They always email us if they are concerned about anything in a timely manner.”

There were enough permanent and agency staff on duty and rotas showed staffing levels were adequate. People and staff confirmed that staffing had been a challenge during a recent Covid-19 outbreak but the dependency on agency staff had reduced and recruitment was going well. Staff confirmed there were generally enough staff available to support people living at the service and to meet their individual needs.

There were walkie-talkie handsets in place to support staff to communicate when working throughout the service. There were still occasions when handsets were either not working or not being used by some staff. This was being closely monitored by the manager and office manager. The provider acknowledged this issue at the last inspection and told us they were looking at replacing the current system with a more reliable one. This had not yet taken place. We have made a recommendation about this in the well led section of this report.

The service had completed moving people’s paper care plans to an electronic care planning system. This had improved how people’s needs, risks and reviews were recorded. Whilst not all staff had completed specific formal training on line to use the new electronic system, we were assured that all staff were using it to some extent at the time of this inspection.

Handover records had improved and contained information on people’s health conditions and needs. This included where people needed their nutrition and fluids monitored.

People received their medicines as prescribed. Paper medicine administration records were being used. There were regular checks and audits of aspects of medicines management and this monitoring was identifying further improvements which were being implemented.

People were relaxed and comfortable with staff and had no hesitation in asking for help from them. Staff were caring and responded to calls for support from people in a timely manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Accidents and incidents were recorded and monitored. Regular audits of these records showed the service had taken action to support people where patterns and trends were evident.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Staff were informed about people’s changing needs through shift handovers and records of the care provided for people.

People told us they felt safe and happy living at The Grove. Comments included, "Everything is really fine now," "I tell the (staff) if there is anything wrong, and they sort it all out” and “We looked at a lot of places before I came here and we knew immediately that this was the one, and I am very happy here. The food is good and I am fussy, but I always have something to eat that I like offered to me.”

Staff morale had improved and they were happy working at the service. Staff told us, “I left when things were bad last year but as soon as I heard things had improved so much I came back. Several of us did this,” “It is so much better now. I love it here” and “The manager and the office manager are amazing they have really made a difference here.”

The service had found it challenging to recruit to a vacant chef post. People told us they had been aware of changes in the kitchen staff and some said changes in the quality of meals had been noticed. However, the manager assured us that a new chef was about to commence work in the coming weeks.

The service had just come to the end of their first outbreak of Covid-19 since the pandemic began. We were assured that risks in relation to the Covid-19 pandemic had been managed appropriately. Staff had access to appropriate PPE and hand washing facilities, which they used effectively and safely. The service was following current guidance regarding testing and visiting arrangements.

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 required improvement (Published 13 November 2021) At this inspection the service rating has improved to good.

Why we inspected

This focused inspection was to follow up on recommendations made at our last inspection and only covers our findings in relation to the key questions Safe, Effective and Well-led.

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to good. This is based on the findings at this inspection.

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