The Grange - Residential Care

We found the following examples of good practice.

The provider had created a visiting pod in the garden. This meant relatives were able to visit people without entering residential areas of the service. All visitors were required to complete a rapid test for COVID-19 and return a negative result before entering the pod. Staff were observed following current guidelines on the use of personal protective equipment and cleaning visiting areas before and after visits.

People using the service had access to a sensory room with assistive technology. This meant people were able to use many features, such as the lights and the television using contactless technology reducing the risk of transmission of COVID-19. The provider had employed an assistive technology assistant to support people with this and had worked together with the manufacturer to adapt the voice recognition for people living with a speech impairment.

Relatives had received regular updates throughout the pandemic and were involved in the care of their loved ones. One relative commented, “[Person using the service] coped remarkably well with the support of staff who kept us informed about her and aided her to keep in contact with us.” Another relative commented, “The Grange sent us regular detailed and newsy updates by email and we had Zoom meetings which kept us well informed and reassured.”

The Grange Residential is a residential care home for people with learning disabilities. The home can accommodate up to 16 people. At the time of the inspection there were 15 people living at the home. People at the home had a range of disabilities.

People’s experience of using this service:

People were supported to live in a homely environment with a caring team of staff. Mealtimes felt like family occasions with people chatting to each other along with staff. People had access to a range of activities. The registered manager led by example and was consistently visible around the home. One relative told us, “It is 110% fantastic. Every single member of staff is devoted.”

The management team ensured that they worked in line with ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion to ensure that people with learning disabilities can live as ordinary a life as any citizen.

People’s needs were consistently met and assessed to enable improvements and progress in their lives. Risks to people were assessed and managed to balance people’s safety and right to lead a non-restricted life. There were enough well trained staff to ensure people were supported safely at all times.

People were supported to communicate with their relatives and the managers when they were not happy or wanted to change their support. Staff cared about the people they supported and enjoyed working at the home.

People, relatives and staff were engaged by the service via meetings so that everyone could contribute to the development of the service. There was a credible strategy in place with plans for staffing improvements at the service. This was being implemented by the registered manager who was pro-active in considering how the service could be improved.

Rating at last inspection:

Good (August 2016)

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

People had varied communication needs and abilities. Some people were able to express themselves verbally; others used body language, Makaton (type of sign language) or a few key words to communicate their needs.

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. There was a manager in post, and they were in the process of registering with CQC.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks like personal care, activities and the environment and were updated frequently.

There were sufficient staff to keep people safe. There were recruitment practises in place to ensure that staff were safe to work with people.

People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people were assessed to lack capacity to make some decisions, mental capacity assessment and best interest meetings were evidenced.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected. Staff were heard to ask peoples consent before they provided care

People had sufficient to eat and drink. People were offered a choice of what they would like to eat and drink. People’s weights were monitored on a regular basis and people were given extra support with portion control if needed.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place to meet people’s needs. There was an induction programme in place which included staff undertaking the Care Certificate. Staff received regular supervision and all staff had recently received an appraisal.

People were well cared for and positive relationships had been established between people and staff. Staff interacted with people in a kind and caring manner.

People and their relatives were involved in planning peoples care. People’s choices and views were respected by staff. Staff and the manager knew people’s choices and preferences. People’s privacy and dignity was respected.

People received a personalised service. Care and support was person centred and this was reflected in their care plans. Care plans contained sufficient detail for staff to support people effectively. People were supported to develop their living skills to gain more independence.

People told us that the activities on offer had improved and they enjoyed the range of activities.

The home listened to people, staff and relative’s views. The management welcomed feedback from people and acted upon this if necessary. There was a complaints procedure in place which was followed effectively.

The home was well led. The management promoted an open and person centred culture. Staff told us they felt supported by the manager. Relatives told us they felt that the management was approachable and responsive.

There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The manager understood the requirements of CQC and sent appropriate notifications.

The relatives and people that we spoke with told us that the staff always gained their consent before they carried out any care. One relative told us they 'They explain things clearly to ensure he understands.'

All of the people we spoke with felt the premises were appropriate for their needs and offered them a safe and suitable environment.

We looked at staff files and found that the service had developed good recruitment processes that ensured that they employed suitable staff.

The home had systems in place to log any complaints. All of the relatives and people we spoke with told us that they had never felt the need to complain.