The Granby

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified one breach of the legal regulations. Quality assurance systems were not always robust or consistently used to drive improvement at the home. Aspects of record keeping required improvement, this included information recorded in care plans and documentation in relation to people’s support. However, staff spoke positively about the management team and felt they were supported. The service worked in partnership with other organisations to support people and there were systems in place to ensure engagement with the community.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Work was required to improve the culture of the service. This included care practices and reporting and escalating concerns. For example, on both days of inspection the inspectors did not observe staff asking people for their preferences of if they wanted to stay sitting in their wheelchairs. Improvements were needed to ensure learning from incidents and feedback to improve the service.

Meetings were held between registered nurses and senior care assistants. Minutes showed various topics were discussed, however, we were unable to see any evidence of regular meetings with care staff.

Supervisions were themed discussions rather than individualised and there were limited appraisals carried out. The registered manager was planning more regular supervision with staff which would improve the shared direction and culture of the service.

Staff we spoke with felt supported by the management team. They told us the registered manager was approachable. One staff told us, “Yes, [Registered Manager’s] door is always open, and she is really approachable as a manager.”

The service had a register manager in post, however there was limited oversight on the units within the home. The provider was looking to improve the oversight of specific units by introducing unit lead roles which would also support the manager with oversight of the service.

Staff told us they were free to speak up and they were confident to do this should they feel necessary. Despite this we have recorded in the safeguarding section evidence to show that staff had not always understood when to raise concerns to ensure people's safety.

Systems were in place to raise concerns and complaints. However, a relative told us they raised concerns via email to the registered manager and we were unable to see evidence of this being recorded unless they were formal complaints.

There were policies in place in relation to safeguarding and whistleblowing. Staff were aware of how to whistle blow if they felt they needed to. However, as outlined above safeguarding processes had not always been followed.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Systems in place had not always driven improvement at the service. Previous recommendations had not always been implemented, and concerns were not always escalated so any necessary improvements could be made. Senior management told us new roles they were implementing would support with auditing and action planning.

Governance systems were in place, but they were not always effective at identifying or addressing areas for improvements. When audits had identified areas for improvement or themes, they had not always been implemented to develop and improve the service.

Systems in place had not addressed the concerns we found at this inspection in relation to medicines management, staffing and risk management.

The provider did not keep accurate, up to date, and contemporaneous records. This included in relation to people’s health care, care plans and risk assessments. Records were not organised and at times contained inconsistences.

People told us there were no restrictions on friends and family visiting. The service worked in partnership with health and social care professionals and supported people to be engaged in the community.

Leaders supported the engagement of communities by holding events and arranging activities internally and externally in the community. They partnered with companies to support people living at the service to attend excursions further afield.

A health professional told us, “We can get the information we need, if people are busy, I can ring up, they are always available. No trouble getting them to answer the phone. The registered manager is always available and has a good knowledge of people.”

Processes were in place to maintain effective working relationships with other agencies such as healthcare professionals. Newsletters were available giving updates on what was happening at the service.

Areas of feedback were not always reported or recorded to ensure learning could take place. For example, people told us they had raised concerns regarding staff and one person told us about concerns with medicines practices. There were no records of these concerns to ensure they could be addressed, and learning could take place.

The registered manager told us about positive events that had been held such as charity events and BBQS. They had also held events to promote awareness for areas such as sepsis and a health promotion campaign to reduce the chance of choking or swallowing incidents.

Effective processes were not in place to ensure learning and improvement took place. For example, at the last inspection we made a recommendation regarding the monitoring of call bells and ensuring people were responded to in a timely manner. Sufficient learning had not occurred, and we identified the same concerns at this inspection. Concerns had also been raised previously regarding the safety of the staircase and although action was taken at the time there had been a failure to continue this learning and mitigate risk.

Systems were used to gather feedback, but it was unclear how this had been used to learn and develop the service.