Grace House

Updated 28 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008,

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors and an Expert by Experience . An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Grace House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Grace House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We carried out the inspection visit on 24 August 2022. It was unannounced.

What we did before the inspection

Before our inspection, we reviewed the information we held about the home which included statutory notifications and safeguarding alerts. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection .

During the inspection

We spoke with the registered manager, two care workers, five people who used the service and three relatives. We also spent time observing care to help us understand the experience of people who could not talk with us. We looked at three people’s care records and three staff records; we also looked at various documents relating to the management of the service.

Updated 28 September 2022

About the service

Grace House is a residential care home providing personal and nursing care for up to 11 people aged 65 and over, some of whom were living with dementia. At the time of the inspection, there were 10 people living at Grace House which is set out in one adapted building.

People’s experience of using this service and what we found

Staff supported people to take medicines safely. However, we found that unused stocks of medicines had not been returned to the pharmacy in a timely way.

At this inspection we identified shortfalls related to the lack of adequate assessment of risks to people's health and wellbeing and risks associated with delivering care.

The service lacked an adequate systems to monitor and improve the quality and safety of the service provided and there was limited oversight and support from the provider as they had not identified the concerns we found.

People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.

The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity .

People received care and support from a small group of staff most of whom had worked for the service for many years, which provided consistency.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

The manager of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

There was a positive culture throughout the service. Staff told us they enjoyed working at the service and felt valued.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection.

At the last inspection we rated this service good. The report was published on 14 January 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified a breach in relation to good governance and made a recommendation in relation to risk assessments. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect .