About the service:

Grove Residential Home is a care home providing personal care and support for people with mental health needs. The home is registered for seven people.

At the time of the inspection it was providing a service to three people.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

People and relatives told us the service was safe and well led, and staff provided an effective, caring and responsive service.

People were safeguarded from the risk of harm and abuse.

People received safe care from staff who were knowledgeable about the risks and how to manage them safely.

People’s needs were safely met by sufficient and suitable staff.

People’s medicines needs were met safely by staff who were well trained and skilled.

The home was clean. Staff safeguarded people from the risk of infection.

Staff told us they felt well supported.

Staff knew the individual needs for people including their likes and dislikes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's care plans were person-centred. Staff knew how to provide personalised care.

Staff treated people with dignity and respected their privacy. People and relatives were involved in the care planning process and their independence was encouraged.

People and relatives knew how to raise concerns.

People, relatives, staff and health and social care professionals told us they the service was well led. They told us that they found the registered manager approachable.

The provider worked collaboratively with other organisations to improve care.

The provider had effective systems and processes in place to ensure the quality and safety of service.

Rating at last inspection:

Good (report published on 28 November 2016)

Why we inspected:

This was a planned inspection to check that this service remained Good.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Grove Residential Home is a care home without nursing that provides care for up to seven people with mental health needs. The home is set out over two adjoining houses. At the time of our inspection, the service was providing care to seven people, but only five were receiving personal care.

We previously inspected Grove Residential Home in August 2014. At the time of this inspection the service was found to be meeting all standards except that of safety and suitability of the premises. We found that the property was in need of maintenance and refurbishment. At the time of this inspection the provider told us about their plans to remodel the home and how they would be making a planning application to the local authority to do so. Upon inspecting the service in October 2016, we found that the property was in the process of the building works needed to re-model the home and change its layout. Building contractors had commenced work on one part of the home and the registered manager told us the works were aiming to be completed in early 2017.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe and people using the service communicated this to us. Staff demonstrated their knowledge of safeguarding adults and what action to take if they had any concerns. The service reported any accidents and incidents as well as safeguardings to the relevant local authority and to the Care Quality Commission (CQC).

The service had clear risk assessments in place and people using the service were protected from harm where risks were identified. Risk assessments were thorough and contained clear mitigation plans. Risk assessments for the on-going building works were in place for everybody using the service.

Staffing levels were appropriate for the level of need across within the home and staff told us that any absences were always covered. Staff were recruited safely and in line with the relevant checks.

People’s medicines were managed, stored and administered safely and audits were completed to ensure consistency.

The service was effective and we saw that people received care based on best practice from staff who had the knowledge and skills through training and supervision to carry out their roles and responsibilities. Staff told us they were supported in their roles.

Consent to care and treatment was sought and we saw examples of this. Staff had an understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and the registered manager had submitted DoLS authorisations to the CQC.

People were supported to have sufficient to eat and drink and maintain a balanced diet. People told us they enjoyed the food and that it was varied. People told us they had a choice of food that was culturally relevant to their needs. Dietary needs were adhered to and monitored where relevant.

People were supported to maintain good health and have access to on-going healthcare support. Referrals to healthcare professionals were prompt and records of people’s health needs were documented.

The service was caring and we observed positive caring relationships with staff and people using the service. People told us they were happy with their care. People were supported to express their views and be involved in making decisions about their care, treatment and support. People were given choice and independence was promoted. People’s privacy and dignity was respected.

The service was responsive and care planning was thorough and detailed. People’s preferences, wishes and aspirations were identified and people were supported to follow their interests. Care plans were reviewed on a regular ba

This inspection was carried out by a single inspector. We visited the home and considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:-

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found.

Is the service safe?

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People we spoke with told us they felt safe living in the home. We observed how people were supported by the staff. We saw staff treating people with respect and dignity.

People’s individual files indicated risks to the person and how these could be minimised to ensure that they were supported as safely as possible.

Is the service effective?

People’s needs were assessed and care and support was planned and delivered in a way that was intended to ensure peoples safety and welfare. We found that care plans were in place and included information about how to meet people's assessed and individual needs. Staff we spoke with had a good understanding of people's individual needs.

Is the service caring?

People’s views and experiences were taken into account and this informed how their care was delivered. Care records showed people had been involved and consulted about their care. People told us they felt happy and safe living at the home. We saw that staff supported people in a respectful and kind way.

Is the service responsive?

People’s needs were assessed and care was delivered to meet their individual needs. We looked at two care files. These provided information about people’s needs. Care plans gave guidance for staff about how they should meet people’s needs. Daily notes showed that people were taking part in meaningful activities and were being supported to access the local community.

Is the service well led?

The service had a registered manager in place and a clear management structure. Staff we spoke with told us they found the management staff to be approachable and accessible. One member of staff said, “You are supported and can ask lots of question. They are patient and just want to help you do the best job.” Staff received the support and guidance needed to carry out their duties and to meet people’s needs.

Quality assurance and monitoring processes were in place. These included seeking the views of people who used the service.

People we spoke to said they felt well supported by staff. One person said “they look after me well. All the staff care.”

People were supported to be able to eat and drink sufficient amounts to meet their needs. We saw that people were offered drinks and snacks throughout the day during our inspection.

People were not always provided with a choice of suitable and nutritious food and drink. When we visited we found food in the fridge that was out of date.

Care was being provided in an environment that was not suitably designed or adequately maintained. The current layout of the service is two family homes one built in the 1980s and the other in the 1990s.

We looked at the recruitment records of staff. We found that recruitment checks such as references and checks with the Disclosure and Barring Service (DBS) were carried out in each case, prior to staff being employed at the home.

We saw that care records were accurate and up to date and were held securely in a locked filing cabinet in the office.

At this inspection we found all care plans had been reviewed in February 2013. Care plans clearly stated goals to be achieved and we saw they included any changes to support needs that had been identified at peoples care practice assessment (CPA) meetings. All care plans were signed by people using the service.

The manager told us that all staff had received supervision in December 2012 and February 2013. We checked notes from these meetings and saw topics discussed included personal development, work performance, team work and rota issues

Staff we spoke to told they had a performance appraisal where they discussed their training needs with their manager. Staff files confirmed all staff had appraisals in February 2013.

Care planning meetings were held annually and were attended by people who use the service, relatives and professionals. We saw evidence that monthly service user meetings take place and they are attended by all users.

Care plans clearly documented the care and welfare needs of each person. They contained sections on like and dislikes, feelings, hopes and difficulties and activity schedules.

We saw the home had two lounges and was told by the manager and staff that the lounge with the television is used for smoking.

The people attend a caravan holiday annually and we saw evidence to confirm that all users attended this year. One user said “I like the holiday because they let me make my own way there and back and we always have a good time.”

People who use the service said they felt safe in the home and that they would talk to staff or the nurse or doctors next door if they were afraid of anything.

Appropriate arrangements were in place in relation to the recording of medicine. We saw that medicine administration record sheets (MARs) sheet were completed after medication was given.

We saw evidence of some staff training which was provided by the organisation however records showed that aside from safeguarding training staff had not received training since 2006.

The provider took account of complaints and comments to improve the service. There was evidence that investigations took place and appropriate changes were implemented.