Archived: Grange Lea Rest Home

Grange Lea Rest Home is registered to provide accommodation and personal care for up to 20 older people. Refurbishment of the premises resulting in larger rooms means that the service can now accommodate up to 19 people. There were 17 people using the service during our inspection.

The provider is a husband and wife partnership with one of them registered as the manager of the service. 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.

People and their relatives told us the service was safe. There were safeguarding policies and procedures in place, and staff were aware of the action to take if abuse or neglect were suspected. Refresher training in the safeguarding of vulnerable adults was being arranged. Risk assessments and regular checks on the safety of the building, premises and equipment were carried out. Individual risks to people were assessed, and measures put in place to mitigate these risks. Accidents and incidents were recorded and monitored by the provider to identify patterns or trends.

Suitable numbers of staff were deployed during our inspection and recruitment procedures ensured that the suitability of staff to work with vulnerable people was checked prior to appointment. Safe procedures were in place for the ordering, receipt, administration storage and disposal of medicines.

People were supported with eating and drinking. The nutritional needs of people were assessed and action was taken in the event of concerns related to dietary intake. People were offered a choice of meals and alternatives were readily available. Likes, dislikes and special diets were accommodated.

Staff received regular training, supervision and appraisals. Where there were gaps in refresher training, this had been identified and planned. People told us staff were knowledgeable and ensured their physical health and wellbeing needs were met. Staff had received training related to Deprivation of Liberty Safeguards and the Mental Capacity Act, and refresher training was planned. Capacity assessments had been carried out and people had signed consent forms to agree to care and treatment plans in place, and to reside in the home. Where people lacked capacity, applications had been made to the local authority to deprive people of their liberty in line with legal requirements.

All interactions we observed between staff and people were caring and respectful. The privacy and dignity of people was respected, and we received positive feedback about the care provided from people, relatives and visiting professionals. A number of relatives commented positively about the end of life care their family members received and praised the staff and provider highly for the quality of care provided.

Person centred care plans were in place;, these were up to date and reviewed on a regular basis. Some care plans in place to meet the psychological needs of people required more details, and this had been added by the second day of the inspection. A range of activities were available and a volunteer visited the service during our inspection to spend time with people which they told us they enjoyed. A complaints procedure was in place but no formal complaints had been received in the last 12 months. People and relatives told us they had not needed to complain and that any minor concerns were dealt with swiftly and proactively by the registered manager.

People relatives and visiting professionals spoke highly of the provider and registered manager who they found helpful, caring and professional. Regular audits on the safety of the service, care delivered, and records were carried out. Feedback was sought from people, relatives and staff via an annual survey. Staff said they felt well supported but they would like more regular staff meetings. We spoke to the provider about this. The culture of the service was homely and inviting and several people and relatives told us that the home enjoyed an excellent reputation locally which is why they had chosen the service. There were strong links with the community including the local church.

Relationships between people and staff were clearly good. Relatives told us and we saw in practice staff treated people with respect and helped them to remain as independent as possible. One relative said, 'I think they encourage people's independence. They show respect, kindness and even the way staff address people shows respect.'

We found people's needs were assessed and care and treatment was planned and delivered in line with their individual care plans. People and relatives we spoke with were positive about the care and support people received. A relative told us, 'It's just like being at home and getting looked after by your own family.' Another relative said, 'It's first class treatment and care here.'

We found that people were provided with a choice of adequate nutrition and hydration.

We concluded that people were protected against the risk of unsafe or unsuitable premises.

We found that there were suitable numbers of skilled, trained and experienced staff.

We saw that people's personal records, staff records and other records relevant to the management of the home were accurate and fit for purpose.

We established that people expressed their views and were involved in making decisions about their care. We viewed minutes from Residents' Meetings and saw they influenced decisions. For example, we saw people had requested a specific trip, which was then organised. A person told us, "They always ask you and show you plenty of respect."

We noted that care plans were in place to support individual needs and that they were reviewed monthly. We saw one particular plan had been updated to reflect changes in the person's nutritional needs. One person said the home delivered, "Really exceptional care on an individual basis."

We confirmed that there was an up to date safeguarding policy in place and that information about the correct procedures was available. Staff demonstrated an awareness of appropriate action to take if abuse was suspected.

We saw records of regular supervision and appraisal and these highlighted areas for improvement and future training. Staff told us they felt well supported and said the management was, "Very hands on, staff can go to them with anything."

We noted that the provider had a complaints process and that comments were recorded. One person told us, "If I had a problem I would just talk to anyone. They are all very helpful."