CQC report explained · a residential care home
What the CQC found at Victoria Grand
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2023
Rated Requires Improvement; inspectors found unsafe staffing and risk management, limited activities and weak leadership.
This was an unannounced focused inspection on 19 April 2023. Inspectors reviewed Safe, Responsive and Well-led. They spoke with people, a relative and staff, observed care, and checked care and management records.
The home did not always have enough suitable staff, including at night. Risks linked to mental health, medicines, the building and infection control were not always managed properly. People often stayed in their rooms and some felt lonely or bored. Care records were not always personal enough.
Inspectors found some positive points. People said they felt safe and described kind staff. Staff understood safeguarding duties, recruitment checks were completed, medicines administration records were accurate, and the home was working within the principles of the Mental Capacity Act.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Responsive and Well-led were rated Requires Improvement. Effective and Caring were not inspected, so their previous ratings were used in calculating the overall rating.
People felt safe
People told inspectors they felt safe living at the home. Staff understood their safeguarding responsibilities.
“Yes I definitely feel safe here, I wouldn't want to be anywhere else.” from the report
Kind staff
People described staff as kind and caring.
“People told us they felt safe living at the home, and they described kind and caring staff.” from the report
Safeguarding awareness
Staff had safeguarding training and understood that concerns should be reported.
“Staff had received training on safeguarding and demonstrated an understanding of their responsibilities.” from the report
Complaints were acted on
The home recorded complaints and sent written responses. Inspectors were given an example where a complaint led to a new doorbell system.
“Records showed that complaints had been considered and written responses had been sent.” from the report
Too few staff
seriousStaffing levels did not always meet the home's own calculations, including at night. This affected timely care, emergency arrangements and medicines checks.
“Staffing levels were inconsistent and did not match the provider's calculated staffing level requirement.” from the report
Risks were not managed
seriousMental health risks, incidents, environmental hazards and infection control problems were not consistently assessed or dealt with.
“Risks to people were not consistently assessed, monitored and managed safely.” from the report
Isolation and boredom
needs fixingPeople spent much of their time in their rooms and had few meaningful activities or social opportunities. Activities were provided for only a few hours on two afternoons a week.
“People were socially isolated and had limited opportunities to take part in activities that were meaningful and relevant for them.” from the report
Care was task-focused
needs fixingCare records did not consistently describe people's wider needs, including mental health, communication, sensory and end of life preferences.
“Care was planned and provided in a task focused way and did not consider people's whole life needs.” from the report
Weak leadership
seriousQuality systems did not identify important shortfalls. Staff did not always have clear direction, and there was no registered manager in post during the inspection.
“There was not clear leadership at the home.” from the report
- 01How many suitable staff are now planned for each shift, including overnight, and what happens if someone is absent?
- 02How are risks for people with mental health needs, distress or agitation now assessed and recorded?
- 03What regular activities and social opportunities are now available, including support to leave bedrooms or go out?
- 04How have care plans been updated to cover people's personal, communication, sensory and end of life needs?
- 05Who is currently responsible for leading the home, and what progress has been made towards registering the manager with CQC?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 24 August 2023 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, October 2018
Victoria Grand: Rated Good overall; inspectors found safe, kind care, but records and management systems needed improvement.
This was an unannounced comprehensive inspection on 16 and 17 July 2018. Inspectors observed care, meals and medicines. They spoke with people, relatives, staff and a healthcare professional. They reviewed care plans, staff files, medicines records, rotas, complaints and other records.
The home was rated Good for safe, effective, caring and responsive care. People were supported by trained staff who knew them well. Inspectors found kind relationships, enough staff, safe medicines practice, personalised care, activities and good access to healthcare.
The well-led rating was Requires Improvement. Records did not always fully show people's choices, medicine guidance and risk assessments. Inspectors said this had not affected people or put anyone at risk. Overall, the rating stayed Good. The previous problem about consent under the Mental Capacity Act had been addressed, and the effective rating improved from Requires Improvement to Good.
Kind and respectful care
Staff treated people with patience, compassion and respect. They asked before providing care and supported people's privacy, dignity and choices.
“Throughout the inspection we observed that staff spoke to people in a caring, patient and friendly way and always addressed them by their chosen name.” from the report
Safe medicines and staffing
Medicines were stored and administered safely by trained staff. Inspectors and people said staffing levels were enough to meet people's needs.
“Medicines were given and stored safely including medicines that need special storage arrangements.” from the report
Personalised support
Staff knew people well and provided care based on their individual needs and preferences. People were offered activities, outings and one-to-one support.
“People continued to receive personalised care that was responsive to their needs.” from the report
Improved consent practice
The home had acted on the previous inspection's concern about consent. Inspectors found that care and treatment was being provided with people's consent.
“At this inspection, the registered manager was able to demonstrate that care and treatment had been provided with the consent of the person.” from the report
Incomplete care records
needs fixingRecords did not always fully document people's choices, risk assessments and decisions about care. Inspectors said this had not directly affected people, but the records needed improvement.
“Records were not always fully completed regarding choices, medication protocols and risk assessments.” from the report
As-needed medicine guidance
needs fixingRecords did not consistently explain when people needed as-needed medicines or how staff should identify and record that need. The medicines policy was not always followed, and topical creams were not signed for by the person applying them.
“For medicines that people would take as and when they needed (PRN), such as pain relief, consistent guidance was not in the person's medication administration record or their care plans” from the report
- 01What has been done since the inspection to make sure risk assessments are complete, including for people who take medicines independently?
- 02How do staff decide when someone needs an as-needed medicine, and where is this guidance recorded?
- 03How do you check that topical creams are signed for every time they are applied?
- 04How are people's choices and decisions about care recorded and reviewed?
- 05What action has been taken to improve the well-led rating from Requires Improvement?
This was an unannounced comprehensive inspection covering all five CQC questions; the overall rating stayed Good, while the well-led rating fell to Requires Improvement. This explanation was written from the published report of 31 October 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 Victoria Grand
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 January 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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