We carried out a review of the data available to us about Grange View on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Grange View, you can give feedback on this service.
Grange View is a residential care home providing accommodation and personal care for up to seven younger adults with lifelong complex needs associated with learning disabilities and autism. At the time of the inspection the home was fully occupied. The service had been developed and designed taking into account best practice guidance and the principles and values underpinning Registering the Right Support. Staff were highly skilled in supporting people to lead as independently as possible and meaningful lives of their choosing. The service was focused on providing a smooth and meaningful transition for people moving on from children’s services into adult life.
People’s experience of using this service and what we found
The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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. Since the last inspection people's life opportunities and quality of life had greatly improved. This was because of the service's commitment in ensuring each person had an individualised support plan designed with support from the provider’s in-house healthcare professionals.
There were enough numbers of suitably qualified staff to meet people’s individual needs. Risks to people’s well being and safety had been identified and well managed. Where safeguarding concerns or incidents had occurred, these had been reported to the appropriate local authorities. Medicines were managed safely, and staff gave people the right level of support they needed to take their medicines. When employing people, the provider had completed checks to ensure they were suitable to work with vulnerable people.
Staff training and development was on going and they had received specific training to safely support and care for people with complex needs. Staff were regularly supported by the registered manager and their deputy through staff meetings, supervision and appraisals. Where relevant people were fully involved in meal preparations and their nutritional needs were met. People and their families had been fully involved in consenting to the care and support provided. The in-house health professionals, who supported the staff team, worked closely with a variety of external agencies and other health professionals to provide exceptionally detailed support plans to meet people’s physical and emotional needs and to achieve their goals.
Staff respected and valued people as individuals and treated them with respect and made sure their privacy and dignity were maintained. People were fully supported to be in control of their lives and be as independent as possible. People had developed trusting and positive relationships with the staff team. Staff were skilled in the communication needs of people and the in-house professionals used nationally recognised assessment tools to establish people’s abilities, needs and choices. People were empowered in setting their own goals and aspirations. This resulted in people achieving positive and life changing outcomes, including one person planning their move from the home to live in the community.
People were supported to have a very active part in the local community and were encouraged to make friendships outside of the home. With enabling support from staff some people were engaged in paid employment, work placements, college courses, volunteer work and socialised in the local community. Staff were focused on people having as many opportunities as possible for them to gain new skills and become more independent. People knew how they could raise concerns about the service provided.
The provider had employed a new registered manager since we last inspected and jointly they regularly monitored the quality and safety of the service. Governance and quality assurance were well-embedded within the service. The leadership of the service promoted a positive, open culture. The registered manager and staff team worked closely with other agencies and healthcare professionals to make sure people had excellent care. Feedback recently gathered by the provider highlighted that 100% of external professionals and relatives, when asked felt the service was well-led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 13 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Grange View is a detached Victorian property that has been suitably adapted to accommodate up to 11 people aged 18 years and above with complex needs and severe learning disabilities. The home is situated in the small coastal town of Grange Over Sands and provides care and accommodation that promotes independent living and life skills.
The accommodation is over three floors with several large communal rooms including a separate dinning area and a communal kitchen. Rooms are designed to promote independent living and all bedrooms have an ensuite. There are, within the property, two individual apartments with their own access that can be used as completely self contained. There is on site staff accommodation for care staff to sleep in overnight and a small office. At the time of our inspection there were four people living at Grange View.
There was a manager in post who had commenced their application to become registered at the time of the inspection. 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 saw records showing staff had completed training in the safeguarding of vulnerable adults. Where accidents and incidents had occurred we found that these had usually been reported to the appropriate authorities and actions had been taken to reduce any further incidents. During the inspection we found that one incident that had occurred had not been reported in a timely manner and this was addressed immediately by the manager.
We saw that the providers recruitment procedures were robust. This ensured fit and proper persons had been employed. On the day of the inspection we observed staffing levels were made adequate to meet the needs of the people currently living in the home. We saw that staffing levels were flexible and could be adjusted to ensure that people with specific needs could be better supported at times when they most needed it.
Staff training was on going and people had received sufficient training to safely support and care for people living in the home. Staff were supported by the manager and seniors in the staff team through regular staff meetings, supervision and appraisals.
We saw that the service worked well with a variety of external agencies and health professionals to provide appropriate care and support to meet people’s physical and emotional health needs.
We saw that medicines were administered safely and records were appropriately completed. Staff who were responsible for the administration of medications had received the appropriate training. We found the storage facilities in use, for medications, at the time of the inspection were not all safe and the provider took immediate action during the inspection to rectify this.
Observations during our inspection evidenced people were given choices about how they wanted to be supported and how to live their lives. Support was provided in a manner to people that promoted their independence. For example enabling them to independently access activities, education and employment in the local community.
The service followed the requirements of the Mental Capacity Act 2005 code of practice. This helped to protect the rights of people who were not able to make important decisions themselves. Best interest meetings were held to assist people who were not always able to make difficult decisions for themselves and where relevant independent advocacy was arranged.
We saw that people were treated with kindness and respect and they and their relatives made very positive comments about the staff team who supported them.
Auditing and actions that may be required to improve the quality and safety of the service needed to be recorded. We have made a recommendation that the systems and processes used to monitor the quality and safety of the service needed to be more formal.