CQC report explained · a residential care home
What the CQC found at Grenville House
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 problems with infection control, medicines being given at the wrong time and unsafe window restrictors. They also found enough staff and safe recruitment processes.
- Effective?
- Requires improvement
- Some agency staff did not have complete checks of their skills and experience, and agency inductions did not always happen. Records did not always show that consent and best-interest decisions were properly assessed.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well and supported their choices, privacy and independence.
- Responsive?
- Good
- Care plans gave detailed information about people's needs and preferences. People were supported with communication, activities, relationships and complaints.
- Well-led?
- Requires improvement
- There was a clear management structure and staff felt supported. However, audits and records were not reliable enough to identify and address the problems found.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found kind and personalised care, but safety, consent, staffing checks and management systems needed urgent improvement.
This was an unannounced inspection on 13 April 2022. One inspector spoke with people, staff, a manager and relatives, and reviewed care records, medicines, recruitment, training and quality checks. Infection control was also examined.
People told inspectors they were happy and felt safe. Staff were kind, respectful and knew people well. Support was personalised, and people were helped to make choices, stay active and keep relationships.
However, inspectors found problems with infection control, medicines and window safety. Records did not always show that decisions had been made lawfully and in people's best interests. Some agency staff checks and inductions were missing, and management audits had not found these problems.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive were Good. The previous overall rating was Good, published on 24 March 2021.
Kind and respectful care
Inspectors saw good relationships between people and staff. Staff supported people in a dignified and respectful way.
“Staff spoke to people in a dignified and respectful way and it was clear from our observations that people and staff had developed good relationships.” from the report
Personalised support
Care plans contained useful information about people's preferences, needs and history. This helped staff support people in the way they wanted.
“Support plans were informative and provided staff with detailed information on people's likes, dislikes, personal preferences, care needs and medical history.” from the report
Choice and relationships
People were supported to choose how they spent their time, follow interests and maintain contact with family and friends.
“People were supported and encouraged to maintain relationships with friends and family.” from the report
Staffing levels
Inspectors found enough staff to meet people's assessed needs, and recruitment checks were completed before new staff started.
“Staff were deployed in sufficient numbers to meet people's assessed needs.” from the report
Infection control
seriousStaff did not always use masks, hand hygiene or gloves correctly. Cleaning of frequently touched surfaces was also not sufficient.
“People were not always protected from the risk and spread of infection.” from the report
Medicines and environmental safety
seriousOne person's medicines were given in the morning instead of at lunchtime, without the required instructions or agreement recorded. Window restrictors also presented a safety risk.
“People did not always receive their medicines as directed.” from the report
Consent and best interests
seriousRecords did not always show that people's capacity, views and best interests had been properly considered when decisions were made for them.
“people's care records did not always show their consent and/or views had been sought in relation to decisions being made on their behalf” from the report
Agency staff checks
seriousInformation about the skills and experience of some agency staff was missing, and inductions did not always take place. This meant the provider could not be sure they were competent to support people safely.
“This meant the provider could not be assured these staff members had the experience, skills or competence to meet people's needs safely.” from the report
Weak quality monitoring
seriousAudits did not identify the problems found during the inspection. Some care records and agency induction records were incomplete or out of date.
“Systems were either not in place or robust enough to demonstrate the service was being effectively managed.” from the report
- 01What has been done to make sure staff use PPE, hand hygiene and cleaning procedures correctly every day?
- 02How do you now check that medicines are given at the times recorded in the person's care plan and medicine records?
- 03How are Mental Capacity Act assessments and best-interest decisions recorded and reviewed?
- 04How do you check the qualifications, experience and induction of every agency worker before they support people?
- 05What new audits or checks are in place to make sure these problems are found and corrected promptly?
This was an unannounced inspection covering all five key questions and infection prevention and control; the ratings for Safe, Effective and Well-led fell from Good at the previous inspection, while Caring and Responsive remained Good. This explanation was written from the published report of 16 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, March 2021
Victoria House was inspected but not rated; inspectors found generally good infection-control arrangements, with visitor screening changed after the visit.
This was an announced, targeted inspection on 3 March 2021. It looked at infection prevention and control during the coronavirus pandemic, rather than giving a full rating for the home.
Inspectors found good arrangements for PPE, testing, cleaning, social distancing and managing a possible outbreak. People were supported to keep in touch with relatives and to spend their time meaningfully.
There was one weakness. Visitors were checked for infection after entering the home, rather than before entry. After the inspection, the registered manager said this had been changed. The service was inspected but not rated.
PPE and staff training
Staff had received infection-control training and inspectors found that they used PPE correctly and understood how to put it on and take it off.
“Staff had received infection, prevention and control training; they wore PPE correctly, understood the importance of it” from the report
Testing and vaccination
The home had an enthusiastic approach to testing, and the report says the vaccine had been rolled out to people and staff.
“There was an enthusiastic approach to testing, and the vaccine had been rolled out to people and staff.” from the report
Cleaning and hygiene
Cleaning had been increased to include frequently touched areas such as door handles and light switches. People were supported with hand-washing and social distancing.
“Cleaning routines at the service had been increased which now included high touch areas, such as door handles and light switches.” from the report
Outbreak planning
The home had a contingency plan setting out what to do if an outbreak happened. Risk assessments were also in place for people and staff considered vulnerable.
“A contingency plan was in place which detailed the action needed if an outbreak occurred.” from the report
Keeping people connected
People were supported to stay in touch with loved ones and to spend their time meaningfully when they could not go outside the home.
“People were supported to stay in touch with their loved ones and to occupy their time in a meaningful way” from the report
Visitor screening happened too late
needs fixingVisitors completed health checks and had their temperature taken only after entering the home. The manager said this was changed after the inspection so screening happened before entry.
“However, these checks were carried out once the visitor had entered the home.” from the report
- 01Are visitors now screened for signs of infection before they enter the home?
- 02How often are PPE, testing and infection-control procedures reviewed?
- 03What would happen if there were an infection outbreak in the home?
- 04How are people supported to keep in touch with relatives when they cannot go outside?
- 05What are the home's current overall ratings for Effective, Caring, Responsive and Well-led?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; it did not provide an overall service rating or ratings for the other four questions. This explanation was written from the published report of 24 March 2021 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 Grenville House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- March 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
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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