CQC report explained · a residential care home
What the CQC found at Grosvenor Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with sufficient staff, improved recruitment checks, safer medicines processes and updated risk assessments. Hot water temperatures were slightly above the permitted maximum and a gas appliance certificate had expired, but both issues were addressed.
- Effective?
- Good
- Staff knew people well and had training for their specific needs. People were supported with food, drink, healthcare, activities, independence and decision-making.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to make choices, maintain relationships and become as independent as possible.
- Responsive?
- Good
- Care plans were up to date and person-centred. People had a range of activities, accessible information and a complaints process.
- Well-led?
- Good
- The home had a registered manager, stronger audits and an open culture. One required notification had not been submitted because of a provider system failure, but processes were revised afterwards.
What inspectors found, May 2019
Rated Good; inspectors found major improvements and kind, personalised care, with a few safety checks needing attention.
Inspectors visited on 18 and 20 February 2019. The first day was unannounced. They spoke with people, staff, managers and a relative, observed care, and checked care plans, medicines, staffing, recruitment, training, complaints, safety records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safer recruitment, improved medicines management, up-to-date care plans and staff who understood people's needs and choices.
This was a substantial improvement from the previous inspection in August 2018, when the home was rated Requires Improvement. A registered manager was now in post, and the breaches found previously had been met. Inspectors still found that some hot water and gas safety checks needed prompt attention, although these issues were addressed during or just after the inspection.
Significant improvement
The home had improved considerably since the previous inspection. The registered manager was in post and the earlier regulatory breaches had been met.
“At this inspection significant improvement had been made, a registered manager was now in post and the breaches in regulations identified at the last inspection were now met.” from the report
Personalised care records
The care plans inspectors reviewed were current and reflected people's individual needs. People and relatives were involved where appropriate.
“People's care plans we reviewed were up to date and reflected their needs.” from the report
Improved medicines management
Medicines were available, stored safely and given by trained staff. Records were audited and staff competence was checked.
“Medicines were stored safely and processes ensured people's medicines were available and people received them safely when needed.” from the report
Activities and choice
People were offered a range of activities and were encouraged to choose how they spent their time. Inspectors saw people joining in and appearing to enjoy activities.
“There was a variety of activities taking place in the service each day.” from the report
Hot water checks
needs fixingChecks showed that hot water was slightly above the permitted maximum, creating a scalding risk. The issue was pointed out and addressed during the inspection.
“Temperature checks, intended to reduce the risk of scalding, showed the hot water marginally exceeded maximum permitted temperatures.” from the report
Expired gas certificate
needs fixingThe safety certificate for a gas tumble dryer had expired. The appliance was checked immediately after the inspection and was confirmed safe.
“However, the safety certificate for a gas tumble drier had recently expired.” from the report
Missed regulatory notification
needs fixingA provider system failure meant one required notification was not submitted without delay. The home said its processes had been revised to prevent this happening again.
“A failure within this system meant a notification was not submitted when required.” from the report
- 01How do you now check and record hot water temperatures, and what do you do if they are too high?
- 02How do you make sure all gas appliances have current safety certificates?
- 03What changes were made after the provider system failed to submit a required CQC notification?
- 04How are medicines audits and staff competency checks kept up to date?
- 05How are people and their relatives involved in reviewing care plans and choosing activities?
This was a planned inspection of the overall service, including both the care provided and the premises, and all five CQC questions were rated. This explanation was written from the published report of 24 May 2019 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 2018
Rated Requires Improvement, with Safe rated Inadequate; inspectors found serious risks involving staffing, medicines, fire evacuation and premises.
This was an unannounced inspection on 7 and 8 August 2018. The inspector reviewed care, medicine and staff records, observed people and staff, and spoke with staff, relatives and health and social care professionals.
The home provided basic day-to-day care, but inspectors found many shortfalls. Medicines were not always stored safely or ordered in time. There were unsafe fire evacuation arrangements, gaps in staffing, incomplete recruitment checks and risks that were not always identified or reported.
People were treated kindly and respectfully. Their care plans were personalised, staff supported healthcare and dietary needs, and improvements had been made to staff training. However, activities, staff supervision and the home's checks on quality and safety needed improvement.
The overall rating was Requires Improvement. Safe was rated Inadequate and the other four areas were rated Requires Improvement. This was the fourth consecutive Requires Improvement rating. The report records continued breaches and further breaches of regulations.
Kind and respectful care
Inspectors saw staff treating people patiently and kindly. Staff protected privacy and dignity during personal care.
“Our observations also showed that staff carried out their duties respectfully and kindly, respecting people's privacy and dignity and carrying out personal care tasks discreetly.” from the report
Personalised care plans
Care plans described people's needs, communication, preferences and emotional support. People and relatives were involved in planning and reviews.
“Care plans were person centred and reflected people's individual needs and how they preferred to be supported” from the report
Improved staff training
The home had made progress on a previous training shortfall. Staff had completed essential and specialist training, with many holding care qualifications.
“Based on our findings at this inspection we consider the provider has taken appropriate action to develop and address the training needs of staff.” from the report
Support for health and dietary needs
Staff helped people access healthcare and worked with specialist professionals. Staff understood individual dietary requirements and managed PEG routines confidently.
“In all other respects staff were observant and proactive in attending to people's health needs.” from the report
Fire evacuation risks
seriousPeople's evacuation plans depended on equipment and procedures that were unsafe or unavailable. Staff had not been trained to use the specialist evacuation equipment, and two fire exits were not alarmed.
“People were therefore at risk that staff may not be able to evacuate them safely in the event of a fire.” from the report
Staffing levels
seriousThere were periods when people were left unsupervised or without required checks because staff were supporting others. Night staffing was also judged insufficient for an emergency.
“There were not enough staff to support people safely.” from the report
Medicines storage and supply
seriousStorage temperatures sometimes exceeded the recommended limit, and three people's important medicines had run out before the end of the medicines cycle.
“The ordering and storage of medicines were not well managed and could place people at risk.” from the report
Epilepsy and hydration guidance
seriousStaff did not know all the recorded epilepsy triggers, and emergency medicine was not accessible within the required time. Fluid records did not show that a person at risk of dehydration received enough to drink.
“Staff would be unable to access and administer the medicines within this timescale as it was locked away and not easily accessible within the timeframe.” from the report
Weak quality checks
needs fixingThe home's audits and action plan had not identified or resolved several important safety problems. Incident analysis and records of learning were also incomplete.
“The quality monitoring systems had not proved effective in addressing all the shortfalls identified at the previous inspection and bringing about change to improve the service.” from the report
Limited activities
needs fixingSome activities were not suitable or meaningful for people's needs. The sensory room had little equipment, and some planned activities were not recorded as having taken place.
“Activities for people needed improvement, and staff acknowledged this.” from the report
- 01What has been done to make each person's fire evacuation plan safe, and do all staff now have the right equipment and training?
- 02How do you now make sure medicines are stored at the correct temperature and ordered before they run out?
- 03What staffing levels are in place on day and night shifts, and how do you cover times when several people need two-to-one support?
- 04How is emergency epilepsy medicine kept accessible within the required two minutes, and how are staff checked on epilepsy guidance?
- 05What changes have been made to activities, including the sensory room, and how do you check that planned activities actually happen?
This was an unannounced inspection of the whole service and all five CQC questions, including care, premises, records, staffing and management systems. This explanation was written from the published report of 1 December 2018 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 Grosvenor Court
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 3 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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