Archived: Littleport Grange

We carried out an unannounced inspection on 21 August 2015 and we rated the home as good.. After the inspection we received concerns in relation to people being safe and receiving the care and support they require. As a result we undertook a focused inspection on 20 July 2016 to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Littleport Grange on our website at www.cqc.org.uk”

At the time of the inspection there was 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.

People were receiving their medicines as prescribed. Staff had completed training and assessments in the administration of mediation to ensure that they were competent. Risk assessments had been completed to ensure that, where possible and appropriate, risks to people were minimised. Staff were aware of the procedures to follow if they thought someone had suffered any harm.

The CQC is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was acting in accordance with the requirements of the MCA including the DoLS. The provider could demonstrate how they supported people to make decisions about their care and the principles of the MCA were being followed.

There were enough staff on duty to ensure that people had their needs met in a timely manner. Staff received the support and training that they required to carry out their roles effectively.

People were provided with the food and drink that they chose and enjoyed. Relevant healthcare professionals had been involved to ensure that people received the support they needed with eating and drinking. People’s healthcare needs were being met and when required people had been referred to the relevant healthcare professionals.

We visited Littleport Grange at 6:15am as some of the concerns were in relation to staffing numbers at night. We spoke with five people who lived at the home, three staff and the manager. We looked at various records, including staff rotas, a staffing risk assessment and two people's care records.

We considered the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found.

Is the service safe?

There were sufficient staff on duty, both during the day and at night so that the needs of the people living at Littleport Grange were met. There had been a few occasions at night when there had been fewer staff than the number the manager had considered would be ideal. However the manager had completed an assessment of the risks involved in having fewer staff on duty and she had put actions in place to minimise the risks on those occasions. There was no evidence that this had had a detrimental effect on any of the people who lived at the home.

We looked at two people's care records and found that their needs were being met in a safe and appropriate way.

Is the service effective?

People we spoke with told us that they liked living at Littleport Grange. One person said, 'It's very nice.' A second person, who had moved from another care home, told us, 'It was a good move, this is much nicer. I can't fault it.'

We looked at care records for two people who had been named in the allegations. We found that an assessment of each person's needs had been carried out before the person was admitted. This meant that the manager had assured herself that staff at Littleport Grange were able to meet the specific needs of both people.

Care plans were personalised and gave staff clear detailed guidance about how to meet the needs of each individual. One person had only recently moved into Littleport Grange, so staff were still developing this person's care plan as their knowledge about the person increased. Staff had written very detailed daily notes, which gave a clear picture about how the person had spent their day.

Doctors' visits had been requested and arranged for one person, with regard to a specific medical issue. This meant the person's health was being appropriately monitored.

The evidence we found, and the results of the manager's investigations, showed that people were receiving the care they required in the way they wanted it.

Is the service caring?

In the time we spent at Littleport Grange we saw that staff had warm, caring relationships with the people who lived at the home. People we spoke with told us they liked the staff.

Is the service responsive?

We saw that each person's needs were assessed before they were admitted to the home, to ensure that the home's staff could meet those needs. Care plans were developed from the assessment so that staff had clear guidance on the ways in which each person preferred their needs to be met. Senior staff carried out regular re-assessments to ensure any changing needs were included in the care plan.

People told us they had choices in their daily lives. They assured us they were able to get up and go to bed when they wanted to, chose what they wanted to eat and drink, where and when they wanted to eat and how they spent their day.

Is the service well-led?

There was effective leadership in place, which ensured that people's needs were met, that they were kept as safe as possible and that the service provided to people by the staff was of a high quality. Staff praised the manager and the rest of the staff team and told us they were happy to be working at Littleport Grange. One member of staff said, 'I'm enjoying the work'.everyone's been really helpful.' Another told us, 'There's a lovely, friendly bunch here and we've got a really nice, good manager.'

A few days prior to our inspection, the local mental health team had visited Littleport Grange and had asked the manager to complete a report in relation to the allegations made with regard to one person. Following the inspection we asked the manager to respond to all the concerns that were raised anonymously with CQC. The investigations she carried out, and the reports she wrote, were comprehensive. This, and the evidence we found during the inspection, led us to judge that the concerns raised were unsubstantiated.

Although we didn't assess safety and suitability of the premises as part of this inspection the considerable amount of refurbishment and improvement to the building and grounds that has been completed and is still ongoing in parts of the home should be noted.

During this inspection we found that the manager was aware of the requirements under the Mental Capacity Act 2005 but not all of the care staff were aware of their responsibilities regarding assessing people's capacity to make decisions about their care and treatment.

The records showed that people were being cared for and supported in the manner which they prefered and access to healthcare professionals was provided when necessary. Risks to people had been assessed and action taken where appropriate. One person told us, "All the staff are helpful, polite and caring".

All of the staff that we talked with were aware of what they should do if they suspected anyone had been abused. All three people living in the home told us that they felt safe living there.