All inspections: Holcroft Grange Residential Care Home

The inspection took place on 19 May 2016 and was unannounced.

The home was last inspected on 28 September 2015 and required improvement for safe in relation to medicines management, and well led as notifications were not submitted to CQC consistently and as required. At this visit we found improvements had been made.

Holcroft Grange Residential Care Home is a care home situated in the centre of the village of Culcheth. It offers accommodation and personal care for up to forty people and is run by CLS Care Services Limited. The home provides personal care, support and accommodation for up to 40 older people who may also have dementia. On the day of the inspection 37 people lived in the home.

A range of shops and other local facilities are within walking distance of the home and the village is supported by good public transport services.

The home 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.

We found that the storage, administration and disposal of medications was safe.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People’s needs were assessed and care plans identified people’s needs whilst fostering and maintaining independence where possible.

Staff were knowledgeable about the risks of abuse and the reporting processes.

The organisation had thorough recruitment practices so that suitable staff were employed.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

There were systems and processes in place to monitor the quality of the service and address shortfalls.

This inspection was unannounced and took place on the 28 September 2015.

The home was previously inspected in February 2014 when it was found to be meeting all the regulatory requirements which were inspected at that time.

Holcroft Grange is a care home located in Culcheth village. It offers accommodation and personal care for up to 40 older people. At the time of our inspection the service was providing accommodation and care to 38 people.

At the time of the inspection there was a registered manager at Holcroft Grange. 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.

During this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

We found that medicines were not managed in a safe way.

We found that the provider had not consistently notified the Commission of incidents or allegations of abuse in relation to people using the service.

During the day of our inspection, people living at Holcroft Grange were observed to be comfortable and relaxed in their home environment and in the presence of staff.

People using the service and relatives spoken with were generally complimentary about the care provided at Holcroft Grange. For example, we received comments such as: “There is nothing I think is lacking, they know what I need. If I needed a doctor they would get one, if I need an optician I would ask for one”; “The menu is very good. There is a weekly menu board and the only set item is on Friday when there is fish”; “I am quite happy living here”; “I visited other care homes. This is as good as any and better than most” and “They are excellent, they do what they can within the budget. I suspect this is one of the best.”

A number of people using the service and their representatives highlighted concern regarding the usage of agency staff within the home and the potential impact this has on continuity of care. We raised feedback from people using the service regarding the use of agency staff with the manager who informed us that the service had a number of vacant posts which had been advertised and were in the process of being recruited to.

People using the service had access to a choice of wholesome and nutritious meals and a range of individualised and group activities. We saw that there was a programme of activities in place. On the day of our inspection we noted that the activity coordinator had facilitated a number of sessions including gentle chair exercises, sing-a-long to World War 2 songs and bingo which people using the service were observed to participate in and enjoy.

Records showed that people also had access to GPs; district nurses; chiropodists; dieticians; opticians and dentists etc. subject to individual needs.

The provider had developed a care planning model known as ‘My Life Plan’ which incorporated assessments of need, plans of care, evaluation records, a range of risk assessments and other supporting documentation to help identify and control potential risks to people using the service.

Systems had been developed to obtain feedback on the standard of care provided and to respond to safeguarding concerns and complaints.

Staff spoken with confirmed they were supported in their role and had access to induction, ongoing training and formal supervision and appraisal.

We have made a recommendation about the need to source or develop a needs analysis tool and staff deployment tool. This will help to demonstrate that the staffing levels are adequate and being kept under review.

During our visit to Holcroft Grange we talked to four people living at the home,to three staff on duty and to two relatives who were visiting. We also examined life plans (care plans),staff files and policies in use by the home. We observed staff interacting with people who used the service.

People told us that they were happy at the home. One person said "I think it is very nice. People are friendly.The food is good and it is clean." Another said "I cannot fault it."

The life plans were detailed and contained appropriate information about people's needs and how they should be met.

The home was clean and attractively furnished. One person said "The rooms are done properly every day."

The service had various policies and procedures covering recruitment and selection which offered good practise in the safe recruitment of appropriate staff. One person said "They are all very kind."

We noted that an effective system for collecting and responding to comments was in place. One person using the service said "I can't think of anything to complain about."

People using the service at Holcroft Grange confirmed that they were treated with respect and their dignity was maintained. People also told us that they were satisfied with the standard of care provided and were of the opinion that staff understood their needs.

For example, comments included: 'The staff are good. We can joke and have a laugh with them'; 'We are well looked after and are never left thirsty or hungry'; 'I'm much happier for moving here. I am very well cared for and the staff are marvellous.'

Systems were in place to offer protection to the people who use the service from abuse and people spoken with confirmed that they felt safe and had no concerns regarding the care provided. No concerns, complaints or allegations were received from the people using the service during the visit.

People spoken with confirmed they had confidence in the staff that provided care and that there were sufficient staff on duty. Comments received included: 'The girls [staff] do their best for us' and 'The staff are happy, kind and considerate.'

We also received positive comments on the standard of care provided from relatives spoken with. Comments included; 'The staff are helpful and attentive'; 'I don't think you could get a better place to live' and 'We have no concerns or complaints about the standards here.'

We spoke with seven people who were staying in Holcroft Grange. All said they had been asked what their needs were and the registered manager had discussed with them the care the home could provide.

The people we spoke with all said they received the help they needed. One person said "I've been here for two years. I had reservations about coming into a home at first but I've never had any complaints about the care, it's very good'. Others said: " I like living here"; 'I'm perfectly happy here'; 'they look after me well and as a result I'm much better than when I came in'.

We asked people who used the service if they would know how to raise a concern about something that was worrying them. They expressed confidence that if they had a problem they would be able to discuss it with the registered manager and that it would be taken seriously.

People spoke highly of the staff team. Comments included "the staff are very good', "you can ask them for anything and they'll oblige", "there have been some new staff lately, but they're all very nice". All residents spoken with said the staff treated them well and that there were enough staff to support them to fulfil their needs.

A visitor told us that their relative had come to the home for a short stay and liked it so much had decided to move in. This person also said that the staff were very good at keeping them informed and consulting on the care of their relative.

We spoke with the local authority commissioning team, who said they had no concerns about the care provided.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Holcroft Grange Residential Care Home

All Inspections

19 May 2016

During a routine inspection

28/09/2015

During a routine inspection

17 February 2014

During a routine inspection

22 November 2012

During a routine inspection

31 October 2011

During a routine inspection

Reports under our old system of regulation