This inspection took place on 31 May 2018 and was unannounced. The Grove Care Centre is a ‘care home’. 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. The Grove Care Centre is registered for 31 people in one adapted building. On the day of our inspection, 28 people were living at the service and one person was in hospital.

There was a registered manager in post who was available throughout the 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.

People living at the service were protected from harm as the provider had robust processes in place to ensure their safety. Staff supporting people were aware of their responsibilities in relation to protecting people from abuse. They had received appropriate training to support their understanding of any safeguarding issues. The registered manager reported any issues of concern to both the CQC and the local safeguarding teams and worked in an open and transparent manner. There were clear processes in place to ensure lessons were learnt following any incidents or events.

The risks to people’s safety were clearly identified with measures in place to reduce these risks. The environment and essential equipment were well maintained

People were supported by well-trained and competent staff in sufficient numbers to keep them safe. Their medicines were managed safely and people were protected from the risk of infection through good hygiene practices and staff knowledge of reducing the risks of cross infection.

People’s needs were assessed using effective evidenced based assessment tools. these were then used to provide clear guidance for staff to assist them gain a good understanding of an individual’s needs and offer the most effective support to people. Staff were supported with appropriate training for their roles.

People were supported to maintain a healthy diet, with staff showing good knowledge of people’s nutritional and health needs. They received support to manage their health needs through well-developed links with local health professionals. The environment people lived in was a well maintained safe environment which met their needs.

Staff sought consent from people before caring for them and they understood and followed the principles of the Mental Capacity Act, 2005 (MCA). 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 at the service, and relatives were treated with kindness and care by staff who supported people with respect and dignity, and developed positive relationships with people in their care.

People were able to maintain relationships with people who were important to them and relatives felt their views and opinions about their loved one’s care were listened to.

The care people received was person centred and met their individual needs, they were supported to take part in a range of social activities to prevent isolation. People’s wishes in relation to their end of life care were discussed with them so their wishes were known. There was a complaints procedure in place and people knew who to complain to should they have any issues.

The service was well led, the registered manager was visible and supportive towards people, their relatives and the staff who worked at the service. The quality assurance systems in place were used effectively to monitor performance and quality of care. The registered manager responded positively to changes

This was an unannounced inspection carried out on 7 March 2017.

The Grove Care Centre can provide accommodation and personal care for 31 older people. It can also accommodate people who live with dementia and/or people who have a physical disability.

The service was run by a company who was the registered provider. There was 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

Some of the arrangements used to avoid preventable accidents, to store medicines and to promote good standards of hygiene needed to be strengthened. Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse. There were enough staff on duty and

background checks on new staff had been correctly completed.

Staff had received most of the training they needed and they knew how to care for people in the right way. People enjoyed their meals and were assisted to eat and drink enough. Staff ensured that people received all of the healthcare they needed.

The registered persons had ensured that whenever possible people were helped to make decisions for themselves. When this was not possible the registered persons had ensured that decisions were taken in people’s best interests.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had ensured that people only received lawful care.

People were treated with kindness and their right to privacy was respected. Confidential information was kept private.

People had been consulted about the help they wanted to receive and they had been given all of the practical assistance they needed. Care staff promoted positive outcomes for people who lived with dementia and people had been supported to pursue their hobbies and interests. Complaints had been quickly and fairly resolved.

Quality checks had not always effectively resolved problems in the running of the service and people had not fully benefited from staff acting upon good practice guidance. However, people had been consulted about the development of their home and the service was run in an open and inclusive way. Good team work was promoted and staff were supported to speak out if they had any concerns.

We inspected The Grove Care Centre on 19 November 2014. This was an unannounced inspection.

The service provides care and support for up to 31 people, some of whom may experience memory loss associated with conditions such as dementia. When we undertook our inspection there were 30 people living at the service. One of the people was staying at the home on a short term basis.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way in order to protect them. At the time of our inspection there was no one living at the home who had their freedom restricted.

Staff understood the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This meant they were working within the law to support people who may lack capacity to make their own decisions.

People were supported to maintain their independence wherever possible, to feel included in the way the home was run and receive care in the way they wished. Staff provided care and support in a warm and caring manner.

Staff understood people’s needs, wishes and preferences and had received training in order to provide support to the people they cared for.

People and their relatives were able to raise any issues or concerns and action was taken by the manager to address them.

There were clear arrangements in place for ordering, storing, administering and disposing of medication.

People had access to healthcare professionals when they required specialist help.

Staff were responsive to changes in peoples care needs and staff supported people in a safe dignified and respectful way. They also showed us they knew about people's social interests, likes and dislikes.

The manager and deputy manager were well established and provided consistent leadership for the staff team.

We found the service was well led and there were arrangements in place to continually assess and monitor the quality and effectiveness of the services provided for people. The arrangements enabled the provider and manager to take appropriate actions to develop the services and learn lessons from events that took place in the home.

Prior to our inspection we reviewed all the information we had received from the provider. As part of our inspection we spoke with three people who used the service and three relatives about their views of the home. We also spoke with six care workers, a cook, the deputy manager, and the registered manager.

We observed the support staff gave to people who used the service. We also looked at records, including care files of four people and carried out a tour of the building.

We found people were involved in making decisions about the care they received. One person told us, "Staff talk to us nicely and ask us before doing anything." A visiting relative said, “The staff involve us as much as XXX so we can all share our view about the care given.”

People we spoke with said staff were responsive to changes in their care needs. They made comments such as, "I have nothing to grumble about I feel well looked after" and "I feel very safe here because everybody cares about us."

Throughout our visit we saw staff supported people in a safe dignified and respectful way. They showed us they knew about people's needs, interests, likes and dislikes.

We found the service was well led and the provider assessed and monitored the quality of the service provided.

We looked at three people’s care records which included their care plans, risk assessments and health plans. These were clear, person-centred, detailed and provided up to date information on how their diverse needs should be met.

One person told us, “They look after us very well; they often talk to me about my care.” One relative told us, “The care here is excellent, everything is done very well. I have no concerns at all.”

We saw each person’s care plan contained an assessment on their dependency levels for eating and drinking. Each person also underwent an assessment of the risk of dehydration. Fluid intake was monitored closely and we saw records of the daily completion of a fluid balance chart which showed how much fluid people consumed.

At our last inspection on 3 March 2011, we issued a compliance action because we could find no evidence that staff supervisions or appraisals had been undertaken by the provider. At this inspection we saw records of regular staff supervision. The manager told us how appraisals had been scheduled for January 2013; this was confirmed by a member of staff.

People said they felt involved in planning their care and they were supported to be as independent as they were able to. They thought their privacy and dignity had been respected and their independence was promoted. One person told us, “I look after myself.” Relatives we spoke with felt that people had their privacy and dignity respected.

People told us they felt their needs were being met by the support they received and this had been provided in a way they wished it to be. One person said, “The doctor comes to see me here if I am not well.”

We asked people if they felt safe in the home and they said that they did, and they did not feel they had ever been put at risk. One person said, “I feel a lot safer than I did when I was at home.”

People told us that the staff who supported them knew what they were doing and were able to provide them with the support they required. One person said, “They are very good, they earn their money.”

People told us they were able to comment about their experiences in the home. One person told us, “We can say what we like, they want us to.”