Background to this inspection
Updated
12 January 2023
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 was carried out by one inspector.
Service and service type
Graceland Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Graceland Care Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 24 November 2022 and ended on 2 December 2022. We visited the location’s service on 24 November 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with one person who used the service and one relative of a person who used the service about their experience of the care provided. We spoke with four members of staff, including the registered manager, the nominated individual and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included three people's care records and two staff files. A variety of records relating to the management of the service were also reviewed. After the inspection we continued to liaise with the provider to validate evidence.
Updated
12 January 2023
About the service
Graceland Care Home is a residential care home providing accommodation and personal care to up to a maximum of 3 people. The service provides support to people with learning disabilities and/or autistic people living in a 3 bedroomed flat. At the time of our inspection there were 3 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
The service did not sufficiently protect people from the risk of the potential spread of infections. We found no evidence anyone had been harmed. However, this put people at an increased risk of potential harm. There was a lack of specific risk assessments in place for some people. This meant potentially there was not always sufficiently detailed information for staff about the risks to people and how to safely manage them. We found no evidence anyone had been harmed. However, the lack of specific and detailed risk assessment information for staff could put some people at increased risk of potential harm. During our inspection the provider said they would put specific risk assessment information about people and instructions in place for staff to follow.
The service worked in accordance with the Mental Capacity Act 2005. This meant the provider had supported people to make decisions following best practice in decision-making.
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.
The service gave people care and support in a clean environment. People were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
People's equality characteristics and individual diversity were considered when providing their care and support. People's care plans included information for staff to support people with their equality and diversity needs and wishes.
Right Care
People's needs, preferences and choices were assessed. The service worked well with other agencies to provide people with consistent, effective and timely care. People could communicate with staff and understand information given to them because staff understood their individual communication needs. People's care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right Culture
The provider had not always sufficiently assessed, monitored and improved the quality of services provided. This meant the provider had not identified the concerns we found. During our inspection the provider put a programme of audits in place to assess, monitor and improve the quality of services provided. Staff training was not up to date. Some refresher training for staff was overdue. During our inspection the provider arranged for staff to complete the overdue training within 3 weeks.
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and supported their aspirations to live a quality life of their choosing. People and their families were involved in planning their care. Staff valued and acted upon people's and their relative’s views. People's quality of life was enhanced by the service's culture of inclusivity and empowerment. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 27 April 2018).
Why we inspected
The inspection was prompted by a review of the information we held about this service.
This was a focused inspection that considered the key questions safe, effective and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Graceland Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance at this inspection and we have made a recommendation about assessing risks to people.
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.