CQC report explained · a residential care home
What the CQC found at Granby Intermediate Care Hub
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found incomplete risk management records, unsafe environmental issues on the first day, gaps in as-required medicine records and weaknesses in infection-control records. The immediate environmental issues were addressed during the inspection.
- Effective?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This question was not assessed during this focused inspection. People and families nevertheless gave positive feedback about the care and support.
- Responsive?
- Good
- This question was not assessed during this focused inspection. The report says people and family members had regular reviews and opportunities to discuss their views.
- Well-led?
- Requires improvement
- The provider's checks had not identified problems with care records, environmental checks or cleaning records. Provider oversight was limited, although managers accepted the findings and took action.
What inspectors found, June 2022
Granby Intermediate Care Hub was rated Requires Improvement; inspectors found kind, effective support but gaps in safety records and oversight.
The inspection took place on 14 and 23 March and 5 April 2022. It began as a targeted inspection after concerns about COVID-19 visiting arrangements. It was widened to a focused inspection of Safe and Well-led after inspectors found additional environmental safety concerns.
Inspectors found risks had been identified, but care plans did not always explain how to manage them. On the first day, equipment blocked a fire exit and doors to rooms with hazardous equipment were unlocked. These issues were dealt with immediately. Medicine administration was generally safe, but records for some as-required medicines were incomplete. Cleaning records and records of environmental checks were also not detailed enough.
People and families spoke positively about the care. Staff worked well with health professionals, and people often improved their mobility and independence. There were enough staff, safeguarding arrangements were in place, and the home was visibly clean. The overall rating changed from Good at the previous inspection in 2017 to Requires Improvement because Safe and Well-led were both rated Requires Improvement.
Positive outcomes
People receiving short-term reablement support often improved their mobility and independence. Staff worked with physiotherapists, nurses and other professionals to support these outcomes.
“People achieved good outcomes because of the support they received.” from the report
Enough staff
Inspectors found there were enough staff to meet people's needs. People receiving care at home said staff usually arrived on time and did not seem rushed.
“There were enough staff to make sure people received the right care and support within a timely manner.” from the report
Safeguarding
Staff had safeguarding training and understood how to recognise and report concerns. The home had systems for managing safeguarding issues.
“Staff had received safeguarding training and knew how to identify and respond to incidents of concern.” from the report
Medicines usually managed safely
Regular medicines were stored and administered safely. Administration records accurately showed that prescribed medicines were given at the right times.
“People received their prescribed medicines at the right times and medicine administration records (MARs) accurately reflected this.” from the report
Positive relationships
People and families spoke positively about the support. Staff also worked constructively with health and social care professionals.
“We received positive feedback from people and family members about the level of care and support both aspects of the service provided.” from the report
Risk plans were incomplete
seriousCare plans did not always explain how identified risks should be managed. Inspectors said this created a risk of avoidable harm.
“Risks to people's health and wellbeing were not always considered as part of the planning and assessment process.” from the report
As-required medicines
needs fixingSome people did not have plans explaining when as-required medicines were needed or how they would communicate this. Other records suggested the medicines were administered appropriately.
“No plans had been put in place to detail when this medicine would be needed or how people would communicate when they needed it.” from the report
Weak governance records
seriousThe provider's monitoring systems had not identified problems with care records, environmental checks or cleaning schedules. This led to a breach of the governance regulation.
“Governance systems were not always effective at identifying issues and driving improvement.” from the report
Infection-control recording
needs fixingSome staff were not wearing masks correctly, clean aprons were stored near waste bins and cleaning records did not show clearly what had been cleaned or how often. Managers took immediate action when this was raised.
“Whilst some cleaning schedules were in place information was lacking in relation to areas being cleaned and the frequency of tasks being completed.” from the report
- 01How have you updated each person's care plan so that every identified risk has clear instructions for staff?
- 02What checks now prove that fire exits, hazardous-equipment rooms and other parts of the environment are safe each day?
- 03How do you record when as-required medicines are needed, and how each person can ask for them?
- 04What changes have been made to governance and quality checks since the inspection?
- 05How are cleaning areas, cleaning frequency and infection-control practices now recorded and checked?
This was a focused inspection of Safe and Well-led after a targeted inspection about visiting arrangements; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 1 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2017
Granby Intermediate Care Hub was rated Good; inspectors found safe, kind and well-coordinated short-term care.
This was an unannounced inspection on 6 November 2017. Inspectors spoke with eight people staying at the home, one visitor, five staff, the manager and the chef. They also checked three care plans, three recruitment files and other records.
The home provides up to 30 short-term places, mainly for people leaving hospital who need support before returning home. There were 13 people staying there during the inspection. Inspectors found suitable staffing, safe medicines management, clean premises and regular risk assessments.
People spoke positively about the staff's kindness and support. Inspectors also found good working with occupational therapists, social workers, nurses and other services. Care plans were aimed at helping people regain independence and return home.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. It remained Good since the previous inspection. The provider could not complete its usual information return because of technical problems, and inspectors took this into account.
Support to return home
The home worked with occupational therapists, social workers and other services to plan each person's progress and discharge. People were encouraged to practise daily living skills.
“The main objective of the service provided at Granby was to help people to gain independence to enable them to move back to their own homes after a period of support.” from the report
Kind and respectful staff
People described staff as kind and said their privacy, dignity and choices were respected. Staff involved people in their daily recovery and support plans.
“People we spoke with told us they liked the staff and they treated them with kindness.” from the report
Safe care and medicines
Inspectors found regular risk assessments, suitable staffing and medicines administered by trained senior staff. Medicines were stored and recorded safely.
“Medication was well managed. Medication was only administered by senior staff who had undergone specific training which included annual assessments of their competency.” from the report
Joined-up working
Daily meetings brought together staff and professionals to discuss progress and what people needed before going home. Equipment and support were arranged as part of discharge planning.
“This was where the senior support staff, Occupational Therapists and social workers all met to talk about each person's progression and what still needed to be in place before they could be safely discharged.” from the report
Recruitment records
minorSome DBS certificates had not been renewed in line with the home's procedure when inspectors visited. The report says this was an oversight and that all required checks had been completed.
“This information was sent to us after our inspection, as we found some potential DBS certificates during our visit to the home which had not been renewed in accordance with the services procedures.” from the report
Basic care plans
minorInspectors said care plans were basic because most stays were short. They still contained a reasonable amount of information about people's needs, preferences and routines.
“Care plans we viewed were basic in their presentation, due to the service not being a long term placement for most people.” from the report
- 01How will you assess my relative's needs before admission and update their risk assessments during their stay?
- 02What specific goals will you agree with my relative to help them regain independence and return home?
- 03How will you arrange equipment, community care or other support before my relative is discharged?
- 04How will you record and review my relative's medicines, including any controlled medicines?
- 05How can my relative or family raise a complaint, and how will feedback from exit surveys be used?
This was an unannounced inspection covering all five key questions; inspectors reviewed information held by CQC, but the provider's information return was unavailable because of technical problems. This explanation was written from the published report of 13 December 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Granby Intermediate Care Hub
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Granby Intermediate Care Hub →
- December 2017Goodstayed GoodSafe: GoodWell-led: Good
Read what inspectors found at Granby Intermediate Care Hub →
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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91 live-in carers within about an hour of Liverpool
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 83 can care for a couple. 10 years' experience on average.
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