Archived: Grassington House

Updated 10 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on Monday 1 February and Wednesday 3 February 2016 and was unannounced. The inspection was carried out by an inspector and inspection manager on the first morning of the inspection, and by a single inspector for the remainder of the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does and improvements they plan to make. We reviewed this information and also looked at notifications which the service had sent us. In addition we contacted health care professionals from the local authority quality improvement team and the Clinical Commissioning Group(CCG) who were involved in the care of people living at the home to obtain their views on the service.

During our inspection we spoke with three people using the service, four visiting relatives and one visiting health professional. We also spoke with four members of staff, the registered manager and one of the proprietors. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.

We looked around the home and observed care practices throughout the inspection. We reviewed four people’s care records and the care they received. We looked at the files of staff members working at the home, and reviewed records relating to the running of the service. These included environmental risk assessments, minutes of residents and staff meetings and quality monitoring audits.

Updated 10 March 2016

The inspection took place on 1 and 3 February 2016 and was unannounced.

Grassington House is a small residential home situated in the centre of Dorchester. It is registered to provide care for up to 12 people and had no vacancies at the time of inspection. The home is a semi-detached period property and accommodation is over three floors accessed by a stair lift(second floor) or a small passenger lift(first floor). There is a small formal front lounge in the property and a separate dining room. However people tended to spend the majority of their time in the large conservatory at the rear of the property. All of the bedrooms have call bells and 7 of the rooms have an ensuite bathroom.

The service had a registered manager. 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 consistently stored safely. We looked at how medicines were stored and found that some medicines required separate storage as required by The Misuse of Drugs(safe custody) Regulations 1973. This separate storage provided was not sufficient and the registered manager told us that they would replace this as a priority.

People told us that they felt safe at the service. One person told us “I feel safe living here, the staff are very nice”. We observed staff supporting people to remain safe. For example, we observed that one member of staff noticed that a person was walking without their frame. They linked arms with the person and gently reminded them that they were supposed to use their frame for safety. Another person told us that they felt safe because staff helped them to walk daily and this improved their confidence.

Staff were aware of how to keep people safe and had undertaken safeguarding training. We looked at the staff training matrix which showed what training staff had undertaken. This confirmed that staff had received training in safeguarding adults. Staff were able to explain the signs of abuse and knew where the policy for safeguarding was kept.

People felt that there were enough staff to support them. One person said that the staff were “very nice and very helpful. They always ask what I want”. Another said they “just ask (the staff) and they are always happy to help”.

The service was effective. Staff we spoke to had detailed knowledge about the people they were supporting. All staff received regular bi-monthly formal supervision with the registered manager and also had unplanned supervision as and when required. We looked at the training records for staff which evidenced that staff had undertaken a range of relevant training including fire safety, food hygiene, health and safety, moving and handling, infection control, Safeguarding and Dementia. Staff were aware of the Mental Capacity Act(MCA) and had received training. They were able to explain how they support people with decision making.

The service effectively supported people to maintain a balanced diet. People at the home and visitors spoke highly about the choice and quality of food available. One person told us the “food is excellent, plenty of veggies and a nice pudding”. Another person said “If you don’t like something, just say and they(the staff) will get something else”.

We looked at how the service involved health professionals when people’s needs change. We saw evidence that the service had contacted the GP promptly when there was a recorded weight loss and the care records showed the guidance for staff which the GP had provided. One relative told us that staff “always called the GP or DN promptly off their own back, and then updated me”.

People and relatives told us that the service was caring. One person told us that when they spoke to staff “nothing is too much trouble”. Another said that the “carers are very friendly”. We observed that staff knew the people they were supporting well and the atmosphere was relaxed with staff chatting and sharing appropriate humour with people.

We observed staff attending patiently to people when they needed support. Staff were respectful in their communication and had a good rapport with people. We observed a person walking arm in arm with a staff member to be seated for lunch. They were chatting and the person was engaged and comfortable.

People living at the home were supported to be independent. One person frequently went out independently and during the inspection we observed different people going out for a walk with a member of staff on several occasions. People, visitors and staff told us that there was a strong focus on going out for walks and one person explained that their “mobility has improved and I couldn’t do last year what I can do this year”.

Visitors were welcome at the home at any time. We spoke to people visiting the home during our inspection and they all told us that they were welcome to visit whenever they chose. One person said that they “phone up and come in whenever I want to”. Another said they were “always welcome and visited daily”. The registered manager told us that they maintain good relationships with relatives and friends of past residents.

There was a strong emphasis on social opportunities at the service. People, visitors and staff spoke very highly about the activities and also told us about fundraising activities run by the home. One person told us that they “go out to town every week in (my) wheelchair and go on the outings in the minibus”. Another person told us that they liked “dominoes and Ludo and going out in the minibus”. We observed one staff member walking back into the home arm in arm with a person having been for a walk, we also observed other people individually going out for walks with staff during the inspection.

People were not aware of the complaints policy, however they were able to tell us how they would complain. The service had not received any complaints during the past year. However the registered manager showed us the policy and how complaints were received and followed through.

The leadership and management of the service was good. We spoke with staff about the management and they told us that the registered manager was “there if you need them” and “easy going and easy to speak to”. Staff also told us that the proprietors were “100% for the residents, they come first before anything”.

Staff told us that they felt part of a team that worked well together. One said that “staff communicate well” and another told us “we can discuss things with each other which is always nice”, another described a “good staff group”. We talked to the staff about what would happen if they made a mistake. Staff were consistent in telling us that they would report to the registered manager and would be confident in doing so.

Staff were aware of the Whistleblowing policy but one member of staff said they were not clear about the process. Staff did understand what Whistleblowing meant and told us that they would be confident to report if they needed to.

We looked at how quality and best practice were driven at the service. The registered manager had clear monthly audits in place which covered areas including food and medication. We saw evidence that audits were being completed as scheduled. It was not clear how the audit information gathered was used to improve and drive best practice. The registered manager told us that they were compiling an overall action plan on which to collate the data from the individual audits. This action plan would then use used to drive quality and best practice.