About the service:

Grosvenor Park Care Home is a nursing home that was providing personal and nursing care for up to 57 older people. At the time of the inspection there were 44 people living there. People were living with a range of needs associated with health conditions and old age. There was also a rehabilitation service which could be provided for up to 10 people who were not weight-bearing following an operation. They received specialist support input from a physiotherapist and occupational therapist.

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 were supported by staff who treated them with kindness, respect and compassion. One person said, “They are all kind, they bring a little bit of life into my life.” Staff understood people’s needs, choices and histories and knew what was important to each person. People were enabled to make their own decisions and choices about what they did each day.

People were supported to take part in a variety of activities that they enjoyed and were meaningful. They received support that was person centred, and staff knew them well. Complaints had been recorded, investigated and responded to appropriately.

Staff had a good understanding of the risks associated with the people they supported. Risk assessments provided further information for staff about individual and environmental risks. The home was clean and tidy throughout.

People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. One person told us, “I have no concerns about safety at all.”

People were supported to receive their medicines when they needed them. There were enough staff working to provide the support people needed, at times of their choice. Recruitment procedures ensured only suitable staff worked at the service.

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.

Staff received training that enabled them to deliver the support that people needed. Nurses completed clinical training which reflected the needs of people in the home. Nurses also completed revalidation with the Nursing and Midwifery Council (NMC) to help demonstrate they maintained their knowledge and skills. One person said, “They help me efficiently and are very good at the job and are obviously trained.”

People's health and well-being needs were met. They were supported to access healthcare services when they needed them. People's dietary needs were assessed. They were supported to eat a wide range of healthy, freshly cooked meals, drinks and snacks each day.

The registered manager knew people and staff well. They understood their responsibilities and had a quality assurance framework to support their oversight of the service provided.

Rating at last inspection:

Requires improvement. (Report published 18 June 2018.)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

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.

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

We inspected Grosvenor Park Care Home on 30 April and 8 May 2018 and our visit was unannounced. Grosvenor Park Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

Grosvenor Park Care Home accommodates up to 57 older people. The service provides personal care and support to people with nursing needs and increasing physical frailty, such as Parkinson’s disease, multiple sclerosis and strokes. There is also a rehabilitation service provided for up to 10 people who were non-weight bearing following an operation, with specialised input from a physiotherapist and occupational therapist. We were told that some people were also now living with a mild dementia type illness. There were 49 people living at Grosvenor Park Care Home during our inspection, ten of whom were there for rehabilitation.

The service had a registered manager in place. 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.

Grosvenor Park Care Home was taken over by a new provider in February 2017. This was their first New Approach Inspection and rating.

There were systems and processes to assess and monitor the quality of the service provided. However, we found that audits were not always effective as they had not identified shortfalls in care records, medicine management, staff supervision and staff training. This had the potential to impact on the safety and well-being of people. Risk assessments for people’s health had not been reviewed or updated following changes to their care, despite people’s needs changing significantly. This was because risk assessments did not always reflect people’s mobility changes as they went through their rehabilitation programme or guide staff in how to support people safely. Air mattress settings were not set or checked as per the manufacturers’ guidance to ensure they were used safely and for maximum benefit. Medicine management did not always follow good practice guidelines in respect of ‘as required’ medicines and the use of pain charts. We found that not all lessons learnt from accidents, incidents and mock fire drills had been taken forward to ensure people’s continued safety. The programme of training and supervision identified that some staff were not up to date with essential training and that not all staff had received regular supervision. Following the inspection process we received confirmation that this had been taken forward as a priority.

People were supported to make decisions in their best interests. If there was a reason to question a person’s capacity the provider assessed their capacity to make their own decisions. Staff and the registered manager had a good understanding of the Mental Capacity Act. Where possible, they supported people to make their own decisions and sought consent before delivering care and support. Where people's care plans contained restrictions on their liberty, applications for legal authorisation had been sent to the relevant authorities as required by the legislation.

Staff supported people to eat and drink enough to maintain their health and referred people to other healthcare professionals when a need was identified. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. The service worked well with allied health professionals

Staff had a good understanding of people's needs and treated them with respect and protected their dignity when supporting them. People were very complimentary about the c