Archived: Apley Grange

Updated 5 August 2016

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 provider is 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 22 June 2016 it was unannounced and was carried out by two adult social care inspectors. The nominated individual and the manager were present.

Before the inspection, we reviewed the information we held about the service. This included notifications regarding safeguarding, accidents and changes which the registered provider had informed us of. A notification is information about important events which the registered provider is required to send us by law.

We requested feedback from Healthwatch however none was provided. Healthwatch are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted North Yorkshire County Council to see if they had any feedback about the service, and we have incorporated this in our report.

During the inspection we spoke with seven members of staff this included the manager and nurses, care staff, volunteers and ancillary staff.

We spoke with 13 people who used the service and because not everyone could tell us their views we spent time observing interaction between people and care staff. We spoke with two relatives and a friend who visited people at the service.

We carried out a tour of the premises which included communal areas and people’s bedrooms. We reviewed four people’s care plans and associated records. We looked at medicine administration records for six people.

We reviewed records associated with the running of the service such as staff rota’s, training records, audits and policies and procedures.

Updated 5 August 2016

This inspection was unannounced and took place on 22 June 2016.

Apley Grange is owned by the Society of the Holy Child Jesus which is a religious community of Roman Catholic sisters. The home is registered to provide residential and nursing care for up to 42 people. The service is spilt into three distinct areas; Hilda House which provides support for people who live relatively independently, Margaret’s House which provides nursing care and Cornelia House which accommodates people living with dementia, some of whom require nursing care. Apley Grange is set in extensive grounds and is a short distance away from Harrogate town centre.

At the time of our inspection there were 37 people living at the service.

The service had a manager in post who had submitted an application to the Care Quality Commission to become the 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.

People told us they felt safe and that they trusted the staff caring for them. There were sufficient staff available to meet people’s needs and people were also supported by a pastoral team who were available 24 hours a day to provide religious and emotional support.

The manager and staff knew how to safeguard people and protect them from avoidable harm. Staff had received up to date safeguarding training and were confident any concerns they raised would be investigated appropriately. Risks to people were identified with risk management plans in place to ensure people received the support they needed to stay safe.

Medicines were safely managed. Some people were supported to manage their own medicines. Where this was the case clear risk assessments were in place.

Staff were provided with the support, training and supervision they needed to deliver effective care.

The service followed the principles of the Mental Capacity Act (2005). Detailed mental capacity assessments were completed and we saw evidence the service had taken all practical steps to support people to make their own decisions. Where people were unable to make an informed decision there were best interest decisions in place which took into account their previous known wishes.

People told us the food was of a good standard and lunch time was a relaxed and enjoyable experience.

The décor throughout the service was to a high standard. All areas of the service were light and airy and there was lots of interesting art work on the walls for people to enjoy.

Everyone we spoke with described a high standard of care. People told us kindness and compassion was integral to the service.

Plans were made to support people to direct their care at the end of their life and the service focused on the celebration of life.

There was a strong sense of community within the service and support based on mutual respect. Care plans focused on the strengths people had and what they offered to the service as well as the support they required to live well.

Care planning documentation was in the process of being updated and the new care plans we reviewed were much improved.

People had access to a range of meaningful activities which they told us they enjoyed. Support from a pastoral team complimented the support provided by nursing and care staff and focused on ensuring people’s religious needs were met.

The manager had worked at the service for a number of years, although they were relatively new to the role of manager. People, staff and visitors spoke with confidence about them and described feeling well supported.

The service had an open and transparent culture and there were effective systems in place to monitor the quality of the care provided.