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, October 2017
Rated Good overall; inspectors found kind, safe and responsive care, but leadership and staff background checks required improvement.
Inspectors visited without notice on 4 and 5 September 2017. They spoke with people living at the home, visitors, staff and health professionals. They reviewed care plans, medicines records, staff files, complaints, incidents and quality checks, and observed care and a meal.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines management, suitable care plans, appropriate health support, kind staff and activities that reflected people's preferences.
The Well-led rating was Requires Improvement. Some long-serving staff had not had their Disclosure and Barring Service checks refreshed since 2003, and the policy did not say how often checks should be refreshed. The manager sent an action plan after the inspection.
The home had improved since the July 2016 inspection. The previous breaches of Regulations 9, 12, 15 and 17 had been addressed, and the report says the home was no longer in breach.
Enough staff
Inspectors found enough skilled and experienced staff. People said staff responded promptly and did not make them wait long for help.
“There were enough skilled and experienced staff to ensure the safety of people who lived at the service.” from the report
Kind and respectful care
Staff built good relationships with people and respected their privacy, dignity, choices and personal routines.
“People felt well cared for and were treated with dignity and respect by kind and friendly staff.” from the report
Improved care planning
Care plans had become more detailed and personalised. They gave staff clearer guidance about mobility, meals, personal care and communication.
“At this inspection we found significant improvement in how care plans had been designed, competed and reviewed.” from the report
Safe medicines management
Inspectors found medicines were stored, given, recorded and disposed of appropriately.
“Medicines were managed safely in accordance with current regulations and guidance.” from the report
Activities and family links
People were supported to join activities in the home and community. Family and friends continued to be involved in people's lives.
“People were supported to take part in a range of activities in the home and access the community.” from the report
Background checks for long-serving staff
needs fixingSome staff had not had their DBS checks refreshed since 2003. The report says this created a risk that changes affecting their suitability might not be declared.
“This meant there was a risk employees' may not declare changes which could affect their employment status.” from the report
Some supervision was overdue
minorThe home aimed to provide four supervisions a year for each staff member. Some ancillary staff were behind this target, although the manager sent an action plan.
“Although some ancillary staff were behind this target following our inspection the registered manager sent an action plan identifying how this would be addressed.” from the report
- 01Have all the DBS checks for long-serving staff now been refreshed, and how often are checks reviewed?
- 02What was included in the action plan sent after the inspection, and has every action been completed?
- 03Are all staff now receiving the planned four supervisions each year?
- 04How are changes in people's needs reflected in their care plans and risk assessments?
- 05How can residents and families influence activities, food choices and the day-to-day running of the home?
This was an unannounced follow-up inspection covering the overall quality of the service and checking whether improvements from the July 2016 inspection had been made. This explanation was written from the published report of 4 October 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.
What inspectors found, September 2016
Grosvenor House was rated Requires Improvement; inspectors found kind care and enough staff, but important safety, care planning and management problems remained.
Inspectors visited the home without notice on 22 and 25 July 2016. They reviewed records, care plans, medicines, accidents, complaints, staff files and quality checks. They spoke with people, visitors and staff, and observed care and mealtimes.
People were generally treated with kindness. Medicines were administered safely, staffing levels were sufficient, the building was maintained safely, and people spoke positively about the staff and acting manager. However, risks linked to choking, falls, outings and visitor access were not always managed properly.
The home did not consistently obtain suitable health advice, keep care plans accurate and person-centred, or provide enough social contact for people who stayed in their rooms. Quality checks had not found all these problems. The Requires Improvement rating means the home was not consistently meeting the standards expected, and the report identified four breached regulations.
Kind staff
Inspectors saw warm, patient and respectful interactions between staff and people.
“We saw many kind and genuine interactions between staff and people.” from the report
Enough staff
Staffing matched the planned rota, and people and staff said there were enough workers to provide safe support.
“During our inspection staffing levels matched what was planned on the staff rota.” from the report
Safe medicine administration
Inspectors observed staff checking medicines carefully and confirming that people wanted to take them.
“The care staff gave the medicines and checked and double checked at each step of the administration process.” from the report
Food and mealtimes
People liked the food and choices, and staff supported people at nutritional risk. However, inspectors also found that food was not always served hot.
“People were very positive about both the standard of food and the choices available to them.” from the report
Building checks
Routine checks of electrical systems, the boiler, fire alarm and other equipment were being completed.
“Suitable checks had been undertaken to ensure the safe routine management of the building and environment” from the report
Risks were not always managed
seriousA serious choking incident was not followed up promptly, and a person with repeated falls did not have a suitable mobility risk assessment. A planned trip also had no risk assessment.
“We found a range of risks were not being appropriately managed in relation to peoples care and support needs.” from the report
Security and recruitment checks
seriousThe provider had not assessed the risks of sharing the entrance code. A staff member with unsupervised access did not have the required DBS check in place.
“The provider had not taken steps to assess the risks associated with this.” from the report
Care plans were unclear
seriousSome care plans did not accurately describe people's needs or explain how staff should respond to behaviour, mobility needs and other risks.
“We found multiple examples where care plans were not providing clear guidance for staff on how to respond and support people.” from the report
Limited contact for some people
needs fixingPeople who stayed in their rooms received little one-to-one time apart from personal care and meals. A person's stated wish about family contact at the end of life was not followed.
“people who either chose or were unable to leave their rooms were having limited interaction with the activities coordinator.” from the report
Weak quality checks and records
seriousAudits did not identify all the problems, including patterns in falls and inaccurate daily records. The report also found that some complaints were not recorded or acted on promptly.
“The shortfalls we found at this inspection had only in part been identified by the quality assurance process.” from the report
- 01What changes have you made to assess and reduce choking and falls risks, and can you show us the updated care plans?
- 02How do you now make sure diabetes care and pressure damage prevention are checked with the right health professionals?
- 03How are PRN medicines explained to staff, and how do you record why they were given?
- 04How do you provide regular activities and one-to-one contact for people who stay in their rooms?
- 05How do you check that care records, accident reviews and complaints are complete, accurate and acted on?
This was an unannounced follow-up inspection of the whole service after the April 2015 inspection, using records, observations and discussions with people, visitors and staff. This explanation was written from the published report of 17 September 2016 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
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- October 2017Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.