CQC report explained · a residential care home
What the CQC found at The Grove -6
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 that some fire safety actions had not been completed and that medicine checks were not effective in one case. They also found that staffing arrangements could sometimes limit people's social opportunities.
- Effective?
- Good
- People's needs were regularly assessed. Staff supported people with food, health appointments, exercise, communication, consent and independence.
- Caring?
- Good
- Staff were kind and respectful, knew people well and supported privacy, dignity, choice and independence.
- Responsive?
- Good
- Care plans were personalised and people were supported with activities, relationships, communication, complaints and end-of-life wishes. This rating improved from Requires Improvement at the previous inspection.
- Well-led?
- Requires improvement
- Management monitoring did not always identify or deal with problems quickly enough. Staff training effectiveness and formal supervision were not always checked, although improvement plans had been started.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found kind, personalised care, but safety checks and management oversight were not always effective.
Inspectors made an unannounced visit on 7 and 12 February 2020. They observed care, spoke with people, relatives and staff, and checked care, medicine, staff and management records.
People were generally happy and received kind, respectful and personalised support. Inspectors rated the home Good for effective, caring and responsive care. They found people were supported with health care, food, communication, activities, choice and independence.
The home was not always safe or well-led. Fire safety actions had not been completed promptly, some medicine checks were not effective, and staff training and supervision were not always checked properly. Staffing could also be reduced when staff transported people from the other homes on the same site.
The overall rating was Requires Improvement. This was the second time the home had received this rating, although improvements had been made in complaints, end-of-life planning and personalised support.
Kind and respectful care
People were treated with kindness and respect. Staff knew people's communication styles, interests and support needs.
“People received kind and compassionate care from a staff team who knew them well.” from the report
Personalised support
Support plans focused on people's preferences and needs. People were supported to make choices and develop their independence.
“Support plans were very detailed and focused on people's preferences, likes and dislikes as well as their support needs.” from the report
Activities and relationships
People were supported to take part in activities they enjoyed, both at the home and in the community. Staff also supported contact with relatives.
“People were supported to take part in activities which they enjoyed such as shopping, trips to the zoo, swimming and visits to pubs and restaurants.” from the report
Improvements since the last inspection
The home improved how it recorded and responded to complaints and how it supported people to plan for the end of their life.
“At this inspection we found that improvements had been made.” from the report
Fire safety actions
seriousAn external fire risk assessment identified several improvements, but these had not been completed by the inspection. Some actions were dealt with immediately or planned for the following week.
“These had not been actioned at the time of this inspection.” from the report
Management checks and staff supervision
needs fixingManagement did not always check whether staff training was effective or observe staff practice. Formal supervision was also not being provided in line with the provider's policy.
“Records showed that not all staff members received observations of their competencies in areas such as medicines administration, or supporting people in a person-centred way.” from the report
Staffing and community access
needs fixingStaff sometimes had to transport people from the other homes on the site. This reduced staffing at points and could limit engagement, community activities and holidays.
“People would miss out on engagement with staff, if staff members were required to support the other services with transport.” from the report
One medicine check
seriousPeople were generally supported safely with medicines, but the checks were not effective in one case. Management said improvements would be made.
“The checks in place to ensure that medicines were administered safely was not effective in one case.” from the report
Location and access
minorThe home's location was far from local amenities and public transport was limited. Inspectors said this sometimes restricted access to activities and the community.
“The size of the service had some negative impact on people living there due to the service being located far away from local amenities and having limited access to public transport.” from the report
- 01Have all actions from the October 2019 fire risk assessment now been completed, and can you show us the evidence?
- 02What has changed to make sure medicine checks are effective in every case?
- 03How often are staff observed carrying out their duties and given formal supervision?
- 04How do you make sure staffing remains sufficient when staff transport people from the other homes on the site?
- 05What practical support is available for community activities, given the limited public transport and distance from local amenities?
This was an unannounced inspection covering all five CQC questions; the report says it was planned because of the previous Requires Improvement rating. This explanation was written from the published report of 21 March 2020 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, February 2019
The Grove -6 was rated Requires Improvement; inspectors found kind and skilled care, but concerns about restrictions, records, complaints and oversight.
This was an unannounced comprehensive inspection carried out between 10 October and 16 November 2018. Inspectors observed care, spoke with staff and relatives, and checked care records, medicines, audits and other management systems.
The home had enough suitably trained staff. Medicines were managed safely, people were treated kindly, and staff supported communication, choices, meals, healthcare and activities well.
The overall rating fell from Good at the previous inspection to Requires Improvement. Inspectors found that access to the kitchen had been restricted for everyone without enough recent review, and some care records and end of life information were out of date.
Complaints from people were not recorded or acted on well enough. Quality checks had also failed to identify some of these problems, so the home was not consistently safe, responsive or well-led.
Kind and respectful care
People appeared comfortable with staff. Staff used suitable communication methods and supported privacy, dignity, choice and independence.
“Staff supported people in a calm and kind manner, which showed respect towards them and it was clear that people felt at ease in their company.” from the report
Skilled staff
Staff received an induction, ongoing training, supervision and appraisals. Training covered the specific needs of people living at the home.
“Staff undertook training related to the specific needs of people using the service such as epilepsy, positive behaviour management, and dementia awareness.” from the report
Safe medicines and staffing
Inspectors found enough suitably skilled staff and robust recruitment checks. Medicines records checked were complete and medicines were administered as prescribed.
“There were sufficient numbers of appropriately skilled staff on duty to support people safely.” from the report
Support with activities and interests
People were supported to attend day services, go out, take part in household tasks and follow personal interests.
“People were supported to follow their interests.” from the report
Access to healthcare
The home made timely referrals and supported people to attend appointments with doctors, dentists and specialist services.
“Staff supported people to access additional healthcare when required.” from the report
Kitchen access was too restricted
seriousThe kitchen door had been locked at night for many years because of an old incident. The need for this restriction had not been regularly reviewed, and it affected everyone living at the home.
“This practice restricted all of the people who used the service, whether or not there was a current risk to them individually.” from the report
Care records were out of date
needs fixingSome support plans, risk assessments and guidance had not been fully rewritten for many years. This could mean staff relied on information that was no longer relevant.
“Some records relating to people's support, such as support plans, risk assessments and guidelines had not been fully rewritten for many years” from the report
End of life wishes needed updating
needs fixingSome end of life and funeral information was more than 10 years old. The manager said this would be addressed as a priority.
“However, this information was more than 10 years old in some instances and people's needs and preferences may have changed in this time.” from the report
Complaints were not captured well
needs fixingAlthough people had information about how to complain, the home had not used their communication guidance effectively. Complaints made through changes in mood, behaviour or body language were not recorded in the formal log.
“No complaints made by people in the ways described were recorded in the formal complaints log.” from the report
Quality checks missed problems
needs fixingAudits and provider visits took place, but they did not identify the lack of review of restrictive practices or the outdated records.
“However, we found that these monitoring checks were not always robust enough” from the report
- 01What has changed about the locked kitchen door, and how is the restriction now reviewed to make sure it is the least restrictive option?
- 02Have all support plans, risk assessments and communication guidance been fully reviewed and rewritten where needed?
- 03Have each person's end of life and funeral wishes been discussed and updated?
- 04How can a person who communicates through changes in mood, behaviour or body language make a complaint, and how will it be recorded?
- 05How are people's views gathered directly rather than completed by staff on their behalf?
This was a comprehensive inspection of the whole service, including care, premises, records, medicines, staffing and management systems. This explanation was written from the published report of 21 February 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.
Every inspection of The Grove -6
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- March 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 March 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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