- Care home
Archived: Grindley House Residential Care Home
All Inspections
28 October 2014
During a routine inspection
We inspected this service on 28 October 2014. The service was registered to provide accommodation and personal care for up to 22 people. People who use the service have physical health and/or mental health needs, such as dementia.
At the time of our inspection accommodation and care was provided to 17 people.
The service had 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 and associated Regulations about how the service is run.
At the last inspection on 14 April 2014 we asked the provider to make improvements. These were in relation to the content and accuracy of the information contained in people’s care records, how the quality of care was assessed and monitored and how the staff’s professional development needs were monitored and managed.
During this inspection we found that the registered manager and provider had failed to make the required improvements. This meant the provider had continued to not meet the standards required to meet people’s care and welfare needs.
We also identified additional areas of unsafe, ineffective and unresponsive care. This was because the service was not well led. We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and The Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.
Risks to people’s health and wellbeing were not consistently identified, managed and reviewed and people did not always receive their planned care. This meant people were not always kept safe and their welfare and wellbeing was not consistently promoted.
There were insufficient numbers of staff to keep people safe and provide the right care at the right time. This also meant that people’s individual care preferences and needs were not always met.
Records relating to people’s care were not always accurate, up to date or readily accessible in the event of an emergency situation. This meant people were at risk of receiving unsuitable or unsafe care. Records in relation to the management of the home did not always contain information relating to criminal checks completed on the staff. This meant people could not be assured they were being cared for by suitable staff.
The provider did not monitor the staff’s performance or learning needs. This meant people could not be assured that they were receiving care from staff who were appropriately skilled.
People were at risk of dehydration and malnutrition were not always monitored to ensure they ate and drank sufficiently. When people lost significant amounts of weight the registered manager could not show us that professional advice had been sought. This meant that people’s risks of malnutrition and dehydration were not always managed.
Some people who used the service were unable to make certain decisions about their care. The registered manager and provider could not show us that under these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed. The Mental Capacity Act 2005 and the DoLS set out the requirements that ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. This meant people could not be assured that decisions were being made in their best interests when they were unable to make decisions for themselves.
When staff had the time they supported people with care and compassion and respect. However, we saw that sometimes people were not treated with the care, compassion and respect they should have received.
People’s feedback about the care was sought, but the systems in place to analyse feedback needed to be improved so that feedback could be consistently listened to and acted upon.
The provider did not have effective systems in place to assess, monitor and improve the quality of care. This meant that poor care was not being identified and rectified by the provider.
The registered manager did not inform us of incidents that occurred at the service and pre-inspection information was not completed at our request. This meant we were unaware of incidents that had occurred within the home.
Medicines were given to people in a safe manner. People’s privacy was promoted and people understood the complaints process and the deputy and registered manager’s told us how they would respond to a complaint in accordance with the provider’s policy.
14 April 2014
During a routine inspection
We are changing how we inspect services in the future and also making changes in how we report our findings. This means the summary section of our reports has changed to reflect the questions we now ask. The questions are; is the service safe, is it well led, effective, responsive and caring?
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they were treated with respect and dignity by the staff. We observed people being supported appropriately and sensitively by the staff team. People told us they felt safe, one person said: "I want for nothing" and: "If I need help I just ask".
Sufficient staff were provided to deliver people's care needs and they received the training they needed to provide appropriate care and support.
There were no systems in place to analyse accidents and incidents in the home, to ensure lessons were learned and improvements were made to protect people. Records were not accurately maintained, which meant people may be at risk from unsafe care.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to accurate records and quality assurance.
Is the service well led?
The service didn't have a manager registered with us CQC at the time of the inspection. The acting manager told us that audits and monitoring of the service were taking place, but they had not yet been embedded in all aspects of the service. This meant it was too soon to see if the systems in place were effective in improving the quality of the service.
Staff told us they felt supported by the acting manager and senior staff, but the service had not established a regular programme of one to one supervisions to ensure staff were able to discuss their roles and responsibilities and identify where improvements could be made.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance and staff support.
Is the service effective?
People's health and care needs were assessed with them, but they were not always involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People told us they received the support they needed.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
Is the service responsive?
One person told us they had complained about an aspect of the service some time ago and it had been dealt with properly and promptly. We saw a complaints procedure was in place, but the acting manager told us and showed us that no formal complaints had been recently received.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'They help me to do things for myself' and: "They are so helpful, nothing is too much trouble". One person told us, "If I'm not happy they will sort things out". A relative said, 'I visit my relative regularly. I have been happy with how the staff treat X. I have no concerns".
15 August 2013
During an inspection looking at part of the service
During this inspection we spoke with three people who used the service, four members of staff, the deputy manager and a visiting deputy manager from one of the provider's other care homes.
We found that improvements had been made in medicines management. Systems were now in place to protect people from the risks associated with medicines.
We saw that people were receiving care that met their needs and promoted their wellbeing. However, we found that the information recorded in people's care records did not always match the care they were receiving.
Staffing levels had been reviewed and raised, and we observed care being delivered in a responsive and prompt manner.
We were unable to identify if the provider had become compliant in assessing and monitoring the quality of the service, as this information was not available to us during the inspection. We plan to visit the service again to identify if the required improvements have been made.
16 May 2013
During a routine inspection
People were happy with the food and drink provided. We saw that choices of food and drink were offered and a healthy diet was promoted.
We saw that staff engaged with people in a caring and friendly manner, but on some occasions the care and support people required was not provided in a timely manner.
We found that some people's care needs had not been reassessed or reviewed following a change in their needs. This meant that some people were at risk, because appropriate plans were not in place to meet their needs.
We found that effective systems were not in place to protect people against the risks associated with medicines. During our inspection we saw that some people did not receive the medicines they required in a timely manner or in a manner that promoted their dignity.
We saw that people's care records did not always contain up to date information. This meant that information was not always recorded accurately to guide staff on how to support people.
We found that the provider did not have effective systems in place to monitor the quality of the services provided.
9 November 2012
During a routine inspection
People using the service told us that they felt safe. We observed the way staff interacted with people and saw positive relationships.
People using the service told us that their privacy and dignity were respected, comments included, 'Somehow I just feel comfortable I can't put it into words'. Another person said, 'I think it is great here, the staff are respectful, always answer the buzzer and help me the best they can'.
We looked at the recruitment procedures for staff and found that suitable systems were in place to protect people.
The provider had systems in place to check on the quality of the care people received. We saw complaints were acted upon to improve outcomes for the people who used the service.
13 July 2012
During an inspection looking at part of the service
The visit was unannounced, meaning the service did not know we were going. We spoke with four people using the service and two staff about how the service was delivered, what improvements they had noticed and the quality of service provision.
During our unannounced inspection in September 2011, we made compliance actions in three areas, this meant the provider had to make improvements. We said that the needs of people using the service were not always being met because people had to wait for the staff to be supported. We saw some poor moving and handling practices which may have caused discomfort to people. We said improvements were needed to ensure the environment was safe and we asked for information to be updated. Our visit was to establish that these improvements had been made.
We found that all the necessary actions required had been taken. People spoke well of the service, one person using the service told us, 'I am very comfortable here, they look after us well.'
People using the service confirmed they were seen to promptly if they rang the bell, a staff member told us, 'It has been so much better since we had the extra staff member, we have the time we need now.' This meant people using the service were receiving care and support in a timely manner and when they needed it.
7 September 2011
During an inspection in response to concerns
People told us they were happy with their bedrooms and that they could remain in the privacy of their own room or join other people in the communal areas available. They said their rooms were kept clean, and when they moved into the home they were encouraged to bring some of their personal belongings to make it their own. One person told us, ' My pictures are company.'
People told us that the home had a very good cook and confirmed they were provided with a good choice of food and refreshments and were asked what meal they would like to eat.
Staff had a good knowledge of the care needed and what people's needs were. People who used the service told us, 'I am quite satisfied, thank you.' 'Everyone is very friendly, they get on with their work but we can have a bit of fun with them.'
People were able to see their doctor and receive prompt treatment, one person told us, 'They are very thorough and they come to see us on a regular basis.'
Visitors spoken with considered Grindley House was a good home and they were more than satisfied with the care provided.