Washwood Healthcare Service

Updated 4 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector and an assistant inspector on the first day and one inspector on the second day.

Service and service type

Grassmere Residential Care Home 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 service had a manager registered with the Care Quality Commission. However, the registered manager was no longer working at the home and steps were being taken to remove this registration.

Notice of inspection

This inspection was unannounced and took place on 06 March 2020. We arranged with the manager to return on 09 March 2020 to follow up on information we found on the first day.

What we did:

We looked at information we held about the service, including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders, for example, the local authority and members of the public.

During the inspection, we spoke with six people using the service to ask about their experience of care. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke to one relative who was visiting the home and spoke to another two relatives by telephone for feedback.

We spoke with the provider, the manager and two senior carers and three care staff. We also spoke to one healthcare professional who was visiting the home on the day of the inspection and contacted another healthcare professional for feedback.

We reviewed a range of records. This included four people’s care records and a variety of records relating to the management of the service, including policies and procedures. We looked at three staff recruitment files. Details are in the Key Questions below.

During the inspection CQC received information of concern regarding the approach of staff and the management team. We asked the provider to investigate these concerns and to report back on the actions taken in response.

After the inspection

We continued to seek clarification from the provider to validate evidence found and actions taken following the inspection.

Updated 4 April 2020

Grassmere Residential Care Home is a ‘care home’ that is registered to provide personal care and accommodates up to 26 people living across two floors in one adapted building. Some people were living with dementia; there were also people living with a range of complex health care needs that included those diagnosed with a mental illness. There were 20 people living at the home on the day of the inspection.

People’s experience of using this service:

Since the last inspection in July 2019, some improvements had been made to address the areas we had identified as requiring action, however this inspection found that further improvements were still required.

We found that all required improvements in the infection control processes within the home had not been fully addressed and therefore continued to pose a risk to people’s safety.

The processes in place to monitor, audit and assess the quality of the service being delivered were not fully effective. Although some improvements had been made, we found provider audits had not identified some of the concerns we raised at this inspection.

People were supported to receive their medicines as required to support their wellbeing.

Staff understood of the importance of gaining consent from people before providing support. However, staff spoken with had limited knowledge of the MCA and how this impacted on the care provided to individual people.

Staff received training that was appropriate to them in their role and supported them in providing care in the way people wanted.

We found although some environmental improvements to the design and decoration of the home to support people’s individual needs had been addressed further improvement was still required.

Staff liaised with other health care professionals to meet people’s health needs and support their wellbeing and provided care in the way that people preferred, and people felt able to raise any concerns they may have with staff.

People gave positive feedback about the choice of food provided which they told us they enjoyed.

We people were offered regular drinks throughout the day to support their wellbeing.

People and staff we spoke with told us there had been some improvements in the activities provided. The provider told us activities were under review to ensure they met people’s needs.

Staff felt supported and said they could talk to manager for advice and support and felt confident any concerns would be acted on promptly.

People, relatives and staff spoke of improvement within the service since the last inspection. The provider had a home improvement plan in place to develop the service further and they worked in partnership and collaboration with other key organisations to support care provision.

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 inadequate (published September 2019) and there were multiple breaches of regulation.

This service has been in Special Measures since September 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Enforcement

Since the last inspection in July 2019 there has been a condition placed on the providers registration. This condition instructed the provider to send us regular updates on checks that had been carried out at the service to ensure the quality and safety of the service. The provider has submitted updates as per the condition in place.

This inspection found that whilst some limited improvements had been made the provider remains in breach of regulation 12 (safe care and treatment) and regulation 17 (good governance). The provider was also found to be in breach of regulation 18 (Notification of other incidents). The condition will remain on the providers registration.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.