CQC report explained · a residential care home
What the CQC found at Grosvenor House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2022
Grosvenor House was rated Requires Improvement; inspectors found unsafe risk and medicines management, weak consent records, poor activities and an ineffective quality system.
This was an unannounced inspection on 30 June and 14 July 2022. One inspector spoke with people, relatives, staff and professionals, observed care and checked care plans, medicines records, staff files and management records.
The home supported six people with learning disabilities. Inspectors found staff generally knew people and healthcare needs were met. People had personalised rooms, some local activities and support to keep in touch with relatives.
However, risks were not always assessed properly or followed up after incidents. Medicines records did not always match stock. Mental Capacity Act requirements were not always followed. The environment needed repair, and people often had too few meaningful activities or opportunities to communicate and make choices.
The overall rating and all five question ratings were Requires Improvement. The CQC identified breaches of five regulations, issued warning notices for safe care and good governance, and requested an action plan.
Healthcare support
The home worked with health and social care professionals, and inspectors found evidence that people's healthcare needs were supported.
“Care plans recorded information about people's healthcare needs and there was evidence the provider worked with other professionals including the GP, social workers, speech and language therapist and the district nurse.” from the report
Staff knowledge
Staff generally knew the people they supported and could describe their needs. People and relatives were mostly positive about staff's ability to provide care.
“The staff have a good level of knowledge about [person's] needs.” from the report
Family and community links
People were supported to keep contact with important relatives. Some people were supported to attend places of worship or go for walks.
“Staff supported two people to their place of worship each week.” from the report
Recruitment checks
The home followed recruitment checks intended to help ensure new staff were suitable for their roles.
“The provider followed safe recruitment procedures to help ensure new staff were suitable for the work they were undertaking.” from the report
Risk management
seriousFalls, choking, diabetes and other risks were not always assessed with clear guidance for staff. Incident records did not show effective learning or preventative action.
“We found no evidence that people had been harmed. However, systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Medicines
seriousMedicines stock did not always match the administration records. Inspectors also found missing or extra tablets and gaps in staff competency checks.
“This meant six tablets were missing and unaccounted for.” from the report
Consent and capacity
seriousMental Capacity Act processes were not consistent. Some decisions did not have the required capacity or best-interest evidence, and people without legal authority were asked to give consent.
“MCA principles were not consistently followed.” from the report
Environment
needs fixingSome parts of the home were worn or unsafe. Inspectors found chipped paint, an unstable table and windows without restrictors.
“All the walls and windowsills had chipped paint and were scuffed.” from the report
Meaningful activities
needs fixingPeople often had little meaningful interaction, stimulation or opportunity to choose activities independently. This was linked to a breach of person-centred care requirements.
“Throughout the inspection we observed a lack of meaningful or stimulating interaction, and the opportunity for people to choose to engage activities independently.” from the report
Quality checks
seriousThe home's audits and monitoring systems had not identified or fixed several of the problems found during inspection.
“The provider's quality assurance systems such as audits were not being operated effectively as demonstrated by a number of shortfalls identified during the inspection.” from the report
- 01What has been changed so falls, choking, diabetes and other risks have clear and up-to-date plans?
- 02How do you now check that medicines stock matches the administration records, and that all staff have current medicines competency assessments?
- 03How are mental capacity assessments and best-interest decisions recorded for monitoring equipment, medicines and other restrictions?
- 04What repairs and safety changes have been made to the lounge, furniture and window restrictors?
- 05What regular, personalised activities and communication support are now available for people who do not communicate verbally?
This was an unannounced inspection covering all five key questions, the Right support, right care, right culture principles and infection prevention and control. This explanation was written from the published report of 3 September 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
Rated Good overall; inspectors found safe, kind and personalised care, but the home's leadership needed improvement because required notifications were missed.
This was a comprehensive, unannounced inspection on 23 and 29 November 2017. One inspector spoke with a person using the service, relatives, care workers and the director. They checked care records, medicines, staff files, training records, audits and the home.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found detailed risk plans, safe medicines systems, suitable staff checks and training. People had their health, dietary, cultural and personal needs recorded, and relatives were involved in care planning.
The Well-led rating was Requires Improvement. The home had not told CQC about some applications and outcomes relating to people being deprived of their liberty. This was put right after the inspection, but the home's checks had not spotted the missed notifications. The overall rating improved from Requires Improvement at the previous inspection.
Risk management
People had detailed risk assessments and plans to reduce risks while supporting their independence.
“People had risk assessments and risk management plans to minimise the risk of harm.” from the report
Kind and respectful care
Relatives described staff as kind, respectful and friendly. Inspectors also saw staff respond patiently to people's communication and comfort needs.
“Relatives of people using the service said care workers treated their relatives kindly and with respect.” from the report
Personalised support
Care plans recorded people's likes, dislikes, communication, cultural needs and preferred routines. People and families were involved in planning care.
“People and their families were involved in planning people's care.” from the report
Safe medicines practice
Medicines were stored securely, records were correctly completed and weekly checks showed medicines were being given safely as prescribed.
“Weekly medicines audits indicated that people were receiving their medicines safely as prescribed.” from the report
Missed legal notifications
needs fixingThe home did not notify CQC about some Deprivation of Liberty Safeguards applications and their outcomes on time. The notifications were submitted after the inspection, but the home's quality checks had not found the problem.
“Their quality assurance systems had not identified that the notifications had not been made in a timely manner.” from the report
Activity records
minorPeople were doing activities, but the activity plan was not always followed consistently. Staff said this was because people could agree to or refuse activities.
“People using the service had activity plan and we saw that they did undertake activities according to the plan but this did not always appear to be consistent.” from the report
- 01How do you now check that all Deprivation of Liberty Safeguards applications and outcomes are notified to CQC on time?
- 02Who is responsible for keeping these notifications and renewal dates up to date now that a new manager was due to start?
- 03How do you record activities when a person chooses not to go out, and how do you make sure people still have suitable choices?
- 04What staffing arrangements would be used if all six places were occupied?
- 05How are relatives involved in care plan reviews and decisions about health, activities and end of life wishes?
This was a comprehensive, unannounced inspection covering all five quality areas, with checks of care, medicines, staff records, people's records and the home's management systems. This explanation was written from the published report of 23 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 Grosvenor House
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 12 August 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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