The inspection took place at Granville respite service on the 16 July 2017 and was completed by contacting relatives by telephone on the 19 July 2017. The first day was unannounced. The service was newly registered in June 2015 and this was the first time it had been inspected.Granville is a respite service based in Eccles in the Borough of Salford, Manchester. Granville provides respite stays for up to three weeks for people 14 years of age upwards. The building is split into two accommodation settings. Accommodation to the ground floor caters for adults and consists of 12 bedrooms, as well as bathrooms, lounges, a kitchen and dining area. There are a further two bedrooms, bathroom and lounge area located on the first floor which caters for young people. There is a coded door between the two floors to keep both areas separate, however young people can spend time on the ground floor during the day should they wish to.
At the time of the inspection there was a registered manager who had been registered at the service since June 2015. 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 received positive feedback from people using the service, their families and staff members. Everybody we spoke with felt staff were supportive, friendly, respectful and understood people’s needs. Relatives were confident in the service and its ability to support their relatives safely and effectively whilst providing them with a period of recuperation.
Processes were in place to provide a suitable environment for all people using the respite service and its staff. Risk assessments were established to identify any risks associated with areas such as the use of hoists, bathing facilities, food hygiene and substances hazardous to health (COSHH).
A suitable amount of training and support was offered to ensure staff were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify external agencies where appropriate.
Staffing levels were sufficient to enable safe and personalised care and support to be provided to people using the service. Comments from people using the service, their relatives and staff supported this. Staff were expected to access training which ensured they had the correct skill base and experience to safely, knowledgeably and effectively support people using the service.
Recruitment procedures were in place to ensure appropriate steps had been taken to verify new employee's character and fitness to work. New employee induction processes ensured staff had the correct amount of support and training prior to commencing the role unsupervised. People and their relatives told us staff were knowledgeable about their individual support requirements. Staff demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.
The provider had appropriate processes in place for the safe administration of medicines; this was in line with best practice guidance from the National Institute for Health and Care Excellence. Senior staff were adequately trained in the administration of medicines and all medicines were stored securely and safely.
Each person had their own individual care file containing support plans, risk assessments and other relevant documentation. These records gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated well by means of liaising with families, regular support plan/ risk assessment review and information being recorded in the communication book which meant staff were kept up to date with any changes.
Staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provided legal safeguards for people who may be unable to make their own decisions. The management team also demonstrated their knowledge about what process they needed to follow should it be necessary to place any restrictions on a person who used the service in their best interests.
All people we spoke with along with their relatives and staff, informed us the management structure was adequate and there was always a management presence throughout the service. This meant staff and people were able to seek appropriate advice and support when necessary. Each person informed us they were happy to approach management with any concerns or questions. People felt the registered manager and assistant managers were very supportive and would act on any issues they may have.
We found the ethos of the service was very much about providing a place where people could access respite, whilst feeling safe and being supported to develop the staff and management were very much a part of enabling this to happen.