About the service: Tapton Grove provides mental health services for adults. There are 61 single bedrooms divided over three units; The Coach House, Tapton Grove and Grove House. The Coach House is a 20-bedded residential rehabilitation unit, that prepares people to move into their own homes in the community. Tapton Grove provides nursing and accommodation for up to 23 males with enduring mental health needs. Grove House has two units, both provide nursing and accommodation for up to 10 adults with mental health needs. The home is set in 12 acres of well-maintained grounds and woodland with a lake and is two miles from Chesterfield town centre. There were 53 people using the service on the day of this inspection.

People’s experience of using this service:

Staff knew how to recognise and protect people from the risk of abuse. The infection control practices in place reduced the possibility of people acquiring an infection. People were supported to lead full lives by taking reasonable risks. Where people needed support to take their medicine, this was provided in a safe way. Recruitment checks were undertaken, to determine the suitability of new staff and protect people that used the service.

People were supported to make decisions about what they ate, to ensure the meals met their preferences and dietary needs. Drinks were available to people throughout the day. People using the service for rehabilitation were supported to plan and prepare their own meals. Where people were unable to independently make specific decisions regarding their care; assessments were undertaken to determine the support they needed with these decisions. This ensured people were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. People were involved in their care to enable them to receive support in their preferred way. People had access to healthcare services and received coordinated support, to ensure their preferences and needs were met.

People were supported to take part in social activities of their choice, both in and out of the home to enhance their well-being. People maintained relationships with their family and friends and were supported to raise any concerns and give their views on the service and support they received. Systems were in place to monitor the quality of the service and drive improvement.

More information is in the full report below.

Rating at last inspection: Requires Improvement (report published 23 March 2017).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we saw that improvements have been made.

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.

Tapton Grove is registered to provide accommodation for up to 67 older people, some who are living with dementia, who require personal or nursing care. One part of the service, the Coach House, provides a rehabilitation service. There were 54 people using the service at the time of our inspection.

This inspection took place on 29 and 30 November 2016. The first day was unannounced.

There was a registered manager at the service. 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.

Medicines were not always managed safely. There were recoding errors, some records did not correspond accurately with medicines stocks and guidance for ‘as required’ medicines and specific medicines was not always available. Medicine trolleys were not stored securely to the wall when not in use. Medicine refrigerator temperatures were not consistently recorded. Issues raised via medicines audits were not always acted on.

Routine health checks were not always carried out consistently and records of specific health needs did not confirm that appropriate health care had been provided.

Systems to monitor the quality of the service were not always effective in Identifying issues for improvement.

There were sufficient staff to meet people's needs and staff recruitment practices were satisfactory.

People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure.

Appropriate arrangements were in place to assess whether people were able to consent to their care. The provider was meeting the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). This meant people’s rights were being upheld, and any restrictions in their care were lawful and appropriate.

People told us they enjoyed their food and we saw meals were nutritious.

Staff received relevant training and support to carry out their roles.

People were supported to be involved in their care planning and delivery. The support people received was tailored to meet their individual needs, wishes and aspirations.

People told us the care staff were caring and kind and that their privacy and dignity was maintained when personal care was provided.

There was a wide range of activities and events available to enable people to take part in hobbies and interests of their choice.

Complaints were well managed. The leadership of the service was praised by external professionals and communication systems were effective. The provider had obtained feedback about the quality of the service from people, their relatives and staff.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we took at the back of this report.

Tapton Grove is a home divided into three units for up to sixty-seven people with mental health needs. Fifty- three people were using the service at the time of our inspection visit.

This inspection took place on 4 November 2014.

There was a registered manager at the service at the time of our inspection. 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.

Where people using the service lacked capacity to understand certain decisions related to their care and treatment, the provider was not following the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Although there were restrictions in place for some people, there had been no assessment to determine whether or not this was in people’s best interests.

People using the service were protected from abuse because the provider had taken steps to minimise the risk of abuse. Decisions related to peoples care were taken in consultation with people using the service, their next of kin and other healthcare professionals, which ensured their rights were protected. The premises were safely maintained and medicines were managed safely.

There were enough staff available at the service and staffing levels were determined according to people’s individual needs.

Staff received training to support people with mental health conditions.

Staff were supported through strong links with community healthcare professionals to ensure people received effective care relating to their diet and their ongoing healthcare needs. We have made a recommendation about the use of best practice guidance.

There was a friendly, relaxed atmosphere at the home. People told us they enjoyed living there and their relatives told us that staff were caring and compassionate. People were able to take part in hobbies and interests of their choice and links with community facilities were maintained that helped people who were preparing for independent living.

The registered manager at the home was familiar with all of the people living there and staff felt supported by the management team. The provider had a system in place to obtain feedback from people via meetings and surveys and they told us they felt listened to. There were also regular meetings for staff to contribute to the running of the service. There was a clear complaints procedure that was followed to ensure people’s concerns were addressed.

You can see what action we told the provider to take at the back of the full version of this report.

We talked with people who lived in the home and they said that they were well looked after. They said the staff always asked them how they would like things to be done. They said staff were always mindful of their privacy and treated them with respect.

We found that the service had a robust recruitment process. That process was designed to ensure that the provider only employed staff who were fit to work with vulnerable people.

We saw that the home was clean and tidy but with some disruption as improvement work being carried on in one of the units. People’s bedrooms had been personalised to their own tastes.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, “The staff are very good” and another said, “They’re bang on”.

There was a system in place for assessing and monitoring the quality of the service. This ensured people received a service which was of high quality and met their needs.

We spoke to eight people who resided at the home and six staff including all the deputy managers to find out about the service provided by the home. Some people with dementia were not able to tell us about what it was like at the home.

People were given the opportunity to visit the service being moving in. One person told us they visited on several occasions and that they were happy with the admission process.

People told us about their lifestyles at the home. Some people told us they went out regularly and could follow their own interests. Two people told us they rarely went out but would like to.

We observed positive interactions between people in the home and staff in all three of the units.

It was evident from the interactions and what people told us that people knew the staff well. People readily gave us the names of the staff they would approach if they felt the need to talk to them.

Two people told us that the staff were variable and they “got on better with some staff than others”. One person told us that staff had done a “wonderful job” to help them with a healthcare need they had.

Some people were involved in interviewing staff who would work with them on an individual basis.