1 October 2022
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.
The inspection was undertaken by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Upton Grange 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. Upton Grange is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed the information we had received about the service and contacted the local authority quality and commissioning teams for their feedback. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, the deputy manager, operations manager and four other members of the staff team. We also spoke with six people who lived in the home and eight relatives, about their experience of the care provided.
We reviewed a range of records. This included five people's care records and multiple medication records. We looked at four staff files in relation to safe recruitment. A variety of records relating to the management of the service, including audits were also reviewed.
1 October 2022
About the service
Upton Grange is a residential care home providing support for up to 52 people, some of whom live with dementia. At the time of the inspection, there were 51 people living in the home.
People’s experience of using this service and what we found
Most risks to people were assessed, monitored and mitigated and these were recorded within people’s plans of care. However, there was no evidence that people’s risk regarding COVID-19 had been assessed. These assessments had been archived and the registered manager agreed to review this straight away.
People told us the home was a safe place to be. The building and equipment were well-maintained, and people were supported by sufficient numbers of staff who had been safely recruited. Procedures were in place to manage any safeguarding concerns and staff understood their responsibilities in relation to this.
Safe medication administration procedures and protocols were in place and medicines were administered by staff who had undertaken training and been assessed as competent.
Infection prevention control policies and procedures (IPC) were in place to help reduce the risk of infections, including COVID-19. However, procedures regarding COVID-19 testing for staff require review to ensure all staff consistently undertake tests at the frequency recommended in current guidance. Staff had plenty of PPE available and we saw this was used appropriately. People’s friends and family were supported and encouraged to visit safely.
People’s consent to their care and treatment was sought in line with the principles of the Mental Capacity Act (MCA). 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.
People’s nutritional needs were assessed and met, and people told us they enjoyed the meals available to them. Referrals were made to the dietician or speech and language therapy team as required.
People and their relatives told us staff were caring and treated people with respect. We observed staff engaging with people during the inspection, in a caring and warm manner and people told us they were encouraged to remain as independent as possible. Care files contained detailed, personalised plans of care, which helped to ensure staff knew people’s needs and preferences and how to meet them. People were involved in decisions regarding their care.
People were supported and encouraged to participate in activities and events of interest to them and to maintain relationships that were important to them. There was a variety of activities and events that people could participate in if they wanted to.
A range of audits were completed regularly, that covered all areas of the service. They showed that when areas for improvement were identified, action plans were created and followed up on.
The registered manager was fully aware of their responsibilities and regulatory requirements were met. There were clear systems in place to gather feedback from people, staff and relatives, including meetings and surveys, to help encourage engagement. People and their relatives told us they felt the home was well-managed and staff told us they enjoyed their job and would recommend the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 6 May 2021 and this is the first inspection. The last rating for the service under the previous provider was good (published on 10 January 2020).
Why we inspected
This was a planned inspection of a newly registered service.
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.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.