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Sussex Grange Residential Care Home Good


Inspection carried out on 13 June 2018

During a routine inspection

This inspection took place on 13 June 2018 and was unannounced.

Sussex Grange Residential Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and care for up to 20 older people and there were 17 people living at the home at the time of the inspection. Sussex Grange Care Home is an older style building which has been adapted to a care home. There is a passenger lift so people can access the first floor. All bedrooms are single and have an en-suite toilet. There is a lounge and separate dining room as well as gardens and outdoor space for people to sit.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We made a requirement at the last inspection regarding the Mental Capacity Act 2005 (MCA) as the provider and registered manager were not following the correct procedures when people did not have capacity to consent to their care and treatment. The provider sent us an action plan to say how this was being addressed. At this inspection we found the provider, registered manager and staff had a good awareness of the MCA. Where it was believed people might not have capacity, this was now appropriately assessed and ‘best interests’ decision making procedures implemented when needed. The provider had met this regulation.

People and their relatives spoke highly of the service. For example, one person told us, “As a home, it’s excellent. The food’s excellent , the care’s excellent. We are very well looked after here. I say, 'The Queen couldn’t be treated better.’”

People said they felt safe. Staff were trained in safeguarding procedures and had a good awareness of the importance of protecting people. Risks to people were assessed and action taken to mitigate these.

Medicines were safely managed. Sufficient numbers of staff were provided and checks were made on the suitability of new staff to work in a care setting. The service was clean and hygienic. Reviews of care and incidents took place.

Care staff were supported well and had access to a range of training courses including nationally recognised qualifications in care.

People’s nutritional needs were assessed. There was a choice of food and specialist diets were catered for. People said they liked the food.

The premises were safe, clean and hygienic and suitable for older people.

Staff treated people with kindness and promoted people’s privacy and dignity. Staff demonstrated they had a value base of treating people equally irrespective of their age or disability. Staff knew the importance of providing care and support to people which was individualised and person centred.

People received responsive care to meet their individual needs and preferences. People’s needs were assessed and people were involved in decisions about their care. There was a range of activities for people which they enjoyed as well as access to community facilities.

There was an effective complaints procedure and people and their relatives said they felt able to raise any concerns of issues which were responded to.

The provider had links with local services for people who were at the end of their life. People’s preferences for end of life care were recorded.

The service was well-led with an open culture. There was an emphasis on involving people and relatives in the home and for seeking their views. Staff were supported to develop their skills and knowledge and promoted person centred care. The provider a

Inspection carried out on 17 May 2016

During a routine inspection

The inspection took place on 17 and 20 May 2016 and was unannounced.

Sussex Grange Residential Care Home provides care and accommodation for up to 20 people and there were 19 people living at the home when we inspected. These people were all aged over 65 years and some were living with dementia.

All bedrooms were single and each had an en-suite toilet. The home has a lounge and separate dining room which people were observed using. A passenger lift was provided so people could access the first floor.

The service 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.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the MCA and DoLS. We found the provider and registered manager needed to update their knowledge as well as the service’s procedures where people did not have capacity to consent to their care or treatment and where DoLS were applicable.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to prevent any risk of harm.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

People received their medicines safely.

Staff were motivated and skilled to provide a good standard of care.

There was a choice of food and people said they liked the food. People were supported to receive adequate nutrition and fluids.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular health checks.

Staff demonstrated a caring attitude to people who they treated with kindness and respect. People were able to exercise choice in how they spent their time.

Each person’s needs were assessed and this included obtaining a background history of people. Care plans showed how people’s needs were to be met and how staff should support people. Care was individualised to reflect people’s preferences. Relatives and health care professional said the staff provided a very good standard of care.

Staff supported people with activities and social events were organised based on what people wanted.

The complaints procedure was provided to people and their relatives. People said they had opportunities to express their views or concerns, which were listened to and acted on. There was a record to show complaints were looked into and any actions taken as a result of the complaint.

The management of the service was open to suggestions on how improvements could be made. There was a culture which reflected a service based on meeting people’s needs and obtaining the views of people regarding any improvements. Relatives commented that the staff and registered manager communicated well with them. Staff views were also sought and staff were able to contribute to decision making in the home.

A number of audits and checks were used to check on the effectiveness, safety and quality of the service which the provider used to make any improvements.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 13 August 2013

During a routine inspection

People told us that they received kind, gentle care that met their needs. They said they liked living at the home and that they were afforded plenty of choice about how they lived their life. One relative told us, "We are always made most welcome and feel very much at home." Someone who recently received respite care wrote to say, "The care was excellent. The staff were very good and supportive of my needs."

We spoke with staff who said they enjoyed their work and felt the home provided good care. We were told they would be happy for their relatives to be cared for at the home. The training on offer to staff ensured they were sufficiently skilled and knowledgeable to meet people's needs. They had a good understanding of their roles and the needs of individuals living at the home. Staff and people resident at the home appeared to enjoy each other's company very much.

The care records we looked at provided evidence that the care was planned to meet people's needs and that it was delivered as planned. Attention to detail in recording the care that had been provided showed us that staff observed and reacted to changes in people's condition and needs.

The community nurse we spoke with, along with what people living in the home told us, demonstrated that where staff had concerns about someone, they sought advice from the relevant healthcare professional and where appropriate, discussed the situation with relatives. One family member told us they felt very well informed about the care their relative was receiving and that staff always phoned them if there were any concerns, no matter how small.

Inspection carried out on 28 March 2013

During a routine inspection

We saw that policies and procedures were in place that ensured people's needs and wishes were assessed and recorded appropriately.

People's needs were recorded in a plan of care that was kept under review. Risks to people's safety were assessed and plans to reduce and monitor risks to both people using the service and staff were recorded.

Records showed us that staff received safeguarding training and those that we spoke to were aware of how and when to report any concerns. People using the service told us, " If there is anything that's not right, the staff see to it straight away".

In order to protect people using the service we saw that an appropriate staff recruitment process was undertaken and that staff received training and support suitable to their role.

We observed that staff were respectful and caring as they went about their duties and demonstrated an understanding of individual needs in the planning and delivery of care and treatment.

Records we reviewed showed us that there were processes in place to monitor accidents and incidents and the quality of service being provided. People using the service and their families were involved through annual questionnaires.

We saw that there was a planned programme of activities both at the home and out in the community. One person we spoke to told us they, " really enjoyed going out for coffee in the village" and another person said, " I'm never bored here, there's always something going on".

Reports under our old system of regulation (including those from before CQC was created)