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Beverley Grange Nursing Home Good

Inspection Summary


Overall summary & rating

Good

Updated 19 July 2018

This inspection took place on 4th, 13th and 15th June 2018 and was unannounced.

When we completed our previous inspection on 5th June 2017 we found concerns relating to record keeping processes which were ineffective in monitoring and improving the quality and safety of the service, assessing and mitigating risks and maintaining contemporaneous records of each person using the service. At this time these topic areas were included under the key questions of Responsive and Well-Led. We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework these topic areas are included under the key question of Effective and Well-Led. Therefore, for this inspection, we have inspected these key questions and also the previous key question of Responsive to make sure all areas are inspected to validate the ratings.

Beverley Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beverley Grange provides accommodation and support to a maximum of 75 people some of whom may be younger or older adults that may have physical disabilities and/or living with dementia. At the time of our inspection there were 59 people using the service. The home is purpose built and split into two areas, the first floor is for those people requiring nursing care and the ground floor for people that are more mobile and independent. There are seven bungalows within the grounds of the home three of which were occupied at the time of this inspection. People could live as independently as they could with support available if needed. A large garden with a greenhouse and raised beds of flowers surrounded the home and parking is available on site. The home is located on the outskirts of Beverley in East Yorkshire.

There was a registered manager in post at the time of this inspection. 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.

Staff had exceptional skills and expertise to empower people and their families to be involved in the care planning process. Management supported staff by offering specialist training which supported them to achieve responsive and effective care outcomes.

Records showed staff were innovative and proactive in their approach. Staff worked above and beyond to support people, they arranged multi agency support frameworks, offered support for those transitioning back into the community and worked tirelessly to ensure nursing care was continuously improved to demonstrate high standards of achievement in areas such as pressure care.

Staff were highly skilled at enabling people to explore different innovative communication methods find those that best suited individuals and their capabilities. Relatives told us that staff were patient, friendly and very kind when facilitating people’s freedom to express themselves. This supported an inclusive environment with equal opportunities for all people living at the service.

Relatives feedback praised staff for their kindness and professional manner towards those people requiring palliative care. Staff spoke passionately about ensuring people were comfortable and meticulously cared for during end of life care. Relatives had thanked staff for their exceptional support, care and attention during difficult times.

Staff took time speaking with people about their life histories and captured this information to support people to achieve their future aspirations. People were encouraged to get involved with activities and event planning that incorporated parts of th

Inspection areas

Safe

Good

Updated 19 July 2018

The service remains Good.

Staff were knowledgeable about the different types of abuse and told us they would report to their manager, CQC or the local authorities safeguarding team. Systems were in place for the safe management and administration of medicines.

Recruitment processes were robust and regular supervisions and appraisals supported staff to carry out their role.

Care plans and risk assessments were reviewed monthly and reflective of people's current needs. Records showed that management considered staff skill mix and people's dependency levels to ensure rotas calculated appropriate staffing levels.

Accidents and incidents were recorded with actions taken and an overview to monitor any reoccurring themes.

Effective

Good

Updated 19 July 2018

The service remains Good.

Staff felt supported to carry out their role with a wide variety of training courses available for them to develop their skills and knowledge. Supervisions and appraisals were completed regularly.

Staff understood the importance of obtaining people's consent and ensuring people were supported to make informed decisions. Processes were in place for staff to follow should they have concerns about a persons capacity to make decisions for themselves.

People told us their was plenty of choice during mealtimes and the food looked appetising and hot. Staff took time to support people that required assistance with eating and drinking.

Health professionals told us that all staff followed any advice given to them and worked alongside them to improve people's health and well-being. The premises had signage and personalised information to support orientation for those people living with dementia.

Caring

Good

Updated 19 July 2018

The service remains Good.

People and their relatives told us that staff were kind, helpful and compassionate.

Staff knew people's likes, dislikes and preferences and treated people with dignity and respect at all times. Dignity champions raised awareness around person centred care for people whilst respecting their wishes.

The management team operated an open door policy and we observed staff, residents and people approaching them to discuss various aspects of care and support or to have a day to day conversation.

People had diverse needs and staff were creative in accommodating them and looking for new innovative ways to support them. Equal opportunity policies were in place for both staff and people living at the service to ensure discrimination was not tolerated.

Responsive

Outstanding

Updated 19 July 2018

The service has improved to Outstanding.

Health professionals described the service as incredibly person centred and build around the needs of each individual which ensured positive outcomes were continuously achieved. Care plans empowered people and their relatives to be involved in the care planning process.

Activities and events were organised to incorporate people�s interests and hobbies, families were invited to events to create a fun and socially inclusive environment. The atmosphere staff took time to create was happy, jovial and content.

Staff worked tirelessly to deliver compassionate and high quality standards of care and support to people receiving end of life care, respecting their choices and wishes at all times.

Staff were very knowledgeable, motivated and compassionate when considering innovative ways to support and empower people to communicate and fulfil their own aspirations.

Complaints were investigated, thoroughly analysed and responded to in detail to ensure lessons were learnt to improve outcomes for people.

Well-led

Good

Updated 19 July 2018

The service has improved to Good.

The provider had made several improvements since our last inspection which had a positive effect on the management and leadership of the home.

Quality Assurance processes highlighted areas that required improvements and action plans demonstrated clear guidance of responsibilities and timeframes.

Care plans and risk assessments were regularly reviewed taking into account people's changing needs. Guidance was available for staff on specific health conditions to support them when caring for people with specific needs.

The registered manager was in the process of completing a leadership programme to develop their skills in this field and had signed up to various updates to ensure best practice was adopted in the home.

Annual satisfaction surveys captured people views and suggestions and any actions put on a you say we did whiteboard for visitors and people to view in reception.