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Archived: Pexton Grange Good

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Reports


Inspection carried out on 26 January 2015

During a routine inspection

Pexton Grange provides accommodation and nursing care for up to 57 people. The home is divided into 3 floors, one dedicated to nursing care for older people, one to rehabilitation support for adults of any age and the third to supporting older people living with dementia. Intermediate care beds are provided on each floor. All of the bedrooms are single. A garden and car park are provided. The home is close to bus routes to the city centre.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Pexton Grange took place on 08 July 2013. The service was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 26 January 2015 and was unannounced, which meant the provider and staff did not know we would be visiting. On the day of our inspection there were 56 people living at Pexton Grange.

People told us they were well cared for by staff that knew them well, and they felt safe.

Relatives told us their loved ones were well cared for and they had no worries or concerns about Pexton Grange.

We found systems were in place to make sure people received their medication safely.

Staff were provided with induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home, and their relatives said that they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people were provided with some activities to provide leisure opportunities. However, some people told us activities were limited and they were sometimes bored.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via surveys and the results of these had been audited to identify any areas for improvement.

Inspection carried out on 8 July 2013

During a routine inspection

People living at the home told us that they were happy and that they were satisfied with the care they received. They told us, "the staff are lovely" and "they (staff) have helped me a lot. I can look to the future now.�

Two relatives spoken with said that they were happy with the care their loved one received. Comments included, �I think it is excellent here. The staff are very caring� and �I cannot praise this home enough. My (relative) is content and safe here.�

During the inspection we were able to observe people's experiences of living in the home. The interactions between people living at the home and staff appeared positive. Staff spoken with knew the people living at the home well. We found that care and support was offered appropriately to people.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available. A system was in place to respond appropriately to any complaints received.

Inspection carried out on 10 May 2012

During a routine inspection

We spent the majority of time during the inspection on the dementia unit. Because people with dementia are not always able to tell us about their experiences, we sat in the lounge to observe their mood and how they interacted with staff and their environment. We call this the �Short Observational Framework for Inspection� (SOFI). This involved us observing in a formal way five people who used the service for a period of 40 minutes and recording their experience at regular intervals.

During our time on the unit we saw staff members treated people with respect and courtesy and being kind and supportive to people when engaging with them. Staff spent time talking with people and were seen offering choices where the person�s capacity meant they were able to make choices. For example, whether to get up or not, stay in their room or go to the lounge, which chair to sit in, in the lounge and whether they wanted to go outside or not.

Where needed, staff were seen giving people time to respond where they may have had difficulty understanding what the member of staff was saying to them.

We saw people reacting positively to staff interactions, including smiles and laughter. We saw that staff utilised eye contact and touch to support and engage with people.

We found people were clean and tidy and they appeared to have received a good level of personal care.

We saw that staff demonstrated genuine affection, care and concern for people using the service. Staff members were attentive and provided support when needed, for example, assisting people with drinks and responding when people needed the toilet.

We saw staff offered people moisture wipes to clean their hands and face after they had eaten. Staff were seen to provide this support for those people who were not able to do this themselves.

We saw staff met people�s needs in a safe way, by using appropriate equipment and moving and handling techniques to move them.

We saw people sitting in their rooms and others in the lounge. We spoke with two people in their rooms, but were not able to fully communicate with them. However, both appeared content. One was reading a newspaper and another watching the TV. The programme on the TV did not appear age appropriate, but discussions with staff identified that is what the person liked to watch.

During our SOFI observation soft and calm music was playing. This provided a therapeutic environment for people living at the service. For 15 minutes of the observation one person was very engaged with the music singing and tapping their hands. If a staff member had engaged with them, during the rest of the observation as they did in the afternoon, the person may have been in a more positive mood for a longer period of time.

However, the music was spoiled by the TV also being on with subtitles, which was very distracting. We didn�t see anyone watching the TV. If someone had been watching the TV, it may have been confusing for people with dementia as the sound in the room did not correspond with the programme.

There was one person who was engaged the majority of the time in completing a crossword in the newspaper. A staff member supported the person at one point acknowledging their skills and achievements.

Two people spent the majority of the time during the observation watching what was happening around them, in the main for one person a staff member knitting with another person. They had no interaction from staff during the observation period. One of those people fell asleep. The provider may find this useful to note, because if staff had interacted with them their mood may have been more positive and the person falling asleep may not have done so.

Where possible we did have general discussions with people. One person told us, �It�s alright. It gets a bit boring because they don�t do enough.� They told us they went in the garden sometimes. We saw this person sleep through all but five minutes of our SOFI observation. The provider may find it useful to note their comments, as if staff participated in activities that people had interests in, then they may engage more with their surroundings.

In our general discussions with people, no-one made any comments that would alert us to any concerns about their care, welfare or safety. Neither did we observe any concerns during our SOFI observations.

During our observations as part of the SOFI we were of the opinion there were sufficient staff to meet people�s needs in a timely way.

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