Archived: Grimsby Grange

Updated 23 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

This inspection took place on 24 and 25 November 2015 and was unannounced. The inspection was completed by one adult social care inspector and a specialist professional advisor in dementia.

Prior to the inspection we looked at notifications sent in to us by the registered provider, which gave us information about how incidents and accidents were managed. We spoke with the local authority safeguarding team, contracts and commissioning team and NHS community mental health staff for their views of the service. The commissioning team provided us with information from their recent monitoring visit and community mental health teams commented on their involvement with the service.

We spoke with four people who used the service and five of their relatives who were visiting during the inspection. We also spoke with five health and social care professionals who visited the service during the inspection.

We spoke with the operations manager, registered manager, deputy manager, two senior care workers and three care workers, the cook, two domestic workers and two activity co-ordinators.

A tour of the service was completed and we spent time observing care. We also used the Short Observational Framework for Inspection (SOFI), SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

The care files for six people who used the service were looked at. We also looked at other important documentation relating to people who used the service such as incident and accident records and 16 medication administration records (MARs). We looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty code of practice to ensure that when people were deprived of their liberty or assessed as lacking capacity to make their own decisions, actions were taken in line with the legislation.

A selection of documentation relating to the management and running of the service was looked at. This included three staff recruitment files, the training record, staff rotas, minutes of meetings with staff and people who used the service, complaints and quality assurance audits.

Updated 23 December 2015

We undertook this unannounced inspection on the 24 and 25 November 2015. At the last inspection on 15 and 16 December 2014 we found the registered provider was non-compliant in one of the areas we assessed. We issued a compliance action for concerns about the management of medicines. We rated four of the five key questions we ask as ‘Requires Improvement’ and the fifth as ‘Good.’ During this follow up comprehensive inspection we found improvements had been made in all areas with all key questions rated as ‘Good.’

Grimsby Grange is a purpose built care home situated in Grimsby close to local amenities. The service is registered to provide accommodation and personal care for up to 47 older people some of whom may be living with dementia. There are three floors; with an enhanced dementia unit on the ground floor.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a 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 improvements had been made to the management of medicines in the service. A new electronic medication system had been introduced three weeks before our inspection. People received their medicines as prescribed and they were held securely.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep them safe. At the time of the inspection there were six DoLS authorisations in place and the service was waiting for assessments and approval of the remaining applications they had submitted.

Staff supported people to make their own decisions and choices where possible about the care they received. When people were unable to make their own decisions staff followed the correct procedures and involved relatives and other professionals when important decisions about care had to be made.

We found the service had a relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. We observed staff demonstrated good distraction techniques when managing people who may need additional support to manage their behaviours. They had developed positive relationships with people and their families. We saw people were encouraged to participate in activities and to maintain their independence where possible.

We found people’s health and nutritional needs were met and saw professional advice and treatment from community services was accessed when required. We found people received support in a person-centred way with care plans describing preferences for care and staff following this guidance.

Staff were recruited, trained and supported to meet people’s needs appropriately. We found there were enough staff on each shift to meet people’s needs. Staff told us they felt more supported, they could raise any concerns with the registered manager and felt that they were listened to.

Relatives told us they were aware of the complaints procedure and said issues that they raised were dealt with more efficiently.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager and the operations manager. The reports included any actions required and these were checked each month to determine progress. Improvements had been made with the laundry service, but some relatives felt more could be made. The registered manager was looking into this.

Areas of the home had been refurbished and redecorated but there had been some delays with some flooring renewal which was addressed during the inspection. The registered manager intends to expand the environmental audit processes to ensure any further renewals are carried out more expediently.