This unannounced inspection took place on 20 and 22 March 2018. It was the first inspection of the service since a change of ownership.Florence Grogan House 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.
The home accommodates up to 40 people in purpose-built premises. This includes a specialist unit providing care for ten people who are living with dementia. The home does not provide nursing care.
The home had a registered manager. 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 about how the service is run.
There were enough qualified and experienced staff to ensure that people’s needs could be met. The manager monitored staffing levels regularly using a dependency tool. Robust recruitment procedures had been followed when recruiting new staff to ensure they were of good character.
In general, people’s medicines were stored and handled safely and the manager told us they had worked hard to improve medicines management, however there remained some areas for improvement.
All parts of the premises looked clean, however there was an unpleasant smell of urine in one area which needed to be addressed without delay. Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance person, and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors.
Risk assessments were recorded in people’s care notes and plans put in place to reduce the risks. These were reviewed regularly and kept up to date.
The manager had made appropriate DoLS applications to the local authority. Some of these had been authorised but others were still awaiting consideration. We saw completed consent forms in people’s care notes, and daily records showed evidence of consent being obtained by care staff before support was provided.
People had a choice of meals and malnutrition risk assessments were completed monthly. People at risk were referred to a dietician.
Staff received regular training and supervision to ensure they knew how to work safely and effectively.
All parts of the home were warm and comfortably furnished, with a choice of communal sitting areas.
Visitors we spoke with all described the home as friendly and welcoming. People who lived at the home told us that the staff provided them with good care and support. We observed that staff protected people’s dignity and individuality by respecting their choices and preferences. Personal care was provided in a discreet way and we saw that people were well-groomed and appropriately dressed to their own taste. People were encouraged to be independent and pursue their interests. Some people who did not have close family were supported to access advocacy services.
People’s personal information was kept securely in offices that were code locked and this protected their confidentiality.
People’s care and support needs were assessed before they went to live at the home to ensure that the service would be able to meet the person's individual needs. We saw information in the care plans about people’s likes and dislikes. The care files we looked at showed that people had access to health professionals as needed.
The care plans contained basic relevant information including nutritional assessments and eating and drinking care plans, falls risk assessments and moving and handling plans, personal hygiene care plans and sleep care plans. These had been updated monthly.
People we spoke with said they would be happy to approach the manager with any complaints. The complaints procedure was displayed and advised people who they could contact with any complaints and gave contact details. The manager kept detailed records of complaints that she had received and the records showed that complaints had been investigated, responded to appropriately, and addressed.
Regular meetings were held for staff and for people living at the home.
The manager completed a series of quality audits. These were accompanied by action plans for improvement where needed.
The registered provider is required by law to display their current CQC rating in a prominent place within the service. During the inspection we observed that a summary of the home’s last CQC inspection report, which referred to the previous provider, was displayed.
The registered provider is required by law to notify the CQC of specific events that occur within the service. Prior to the inspection we looked at the notifications that had been submitted by the manager and found that this was being done.