Archived: The Grange & Walton Cottage

We found that there had been uncertainty for people about the closure of one of the homes. We found people had previously been subject to restrictions regarding their food choices, finances and activity. When we inspected improvements had been made to the service. People were involved in making decisions about how they spent their days, what food they chose and how they spent their money.

We spoke with 10 people, three staff and a visiting social worker. People told us they liked living at this service. Some people said they had seen new homes they may move to and were happy with these. There had been a relatives meeting to update and consult relatives about possible alternative accommodation. People were fully aware of the closure of one of the homes and they had been included in discussions about this.

People's food choices had previously been restricted. During this inspection we saw that there were appropriate stores of food and people were being encouraged to make wider food choices whilst being advised about healthy eating. Nine of the 10 people we spoke with said they had plenty to eat at lunch time and they did not mind making packed lunches to have at the on-site day centre. One person said they did not always have enough food but they added that they understood the reason why.

People's finances had been restricted but they were now supported to manage their own spending with advice and support from the staff. Their finances were no longer affecting their ability to take part in their chosen activities.

There were enough staff to support and care for people but the provider may find it useful to note that staff may require further training and guidance in protecting people from abuse and harm.

Below is a summary of what we found. The summary is based on our review of records, speaking with people and their relatives who used the service and speaking with staff who supported the people who used the service.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People who used the service told us they were treated with respect and dignity. For example, one person said, 'I am fully involved in my care'.

We observed the service had a system in place to ensure that people's risk assessments were kept under regular review. Any trends identified were dealt with to minimise risks related to people's health, welfare and safety.

We found that the service did not have a system in place to ensure that all the staff they employed to support people had the required knowledge and skills.

We had not seen any documented evidence that the service used a range of quality monitoring tools to measure the quality of care and support people received from the service. People told us they felt safe with the staff.

Is the service effective?

We found that people's care plans provided detailed information on how they wished to be supported with their care needs. For example, care needs had been clearly stated. We observed that records of people's daily care were documented. Care staff spoken with told us they used the progress sheet to highlight any changes to the person's care to ensure continuity of care. These were appropriately maintained to ensure all members of staff would be able to deliver care safely and effectively.

We found that people's health care needs were kept under review and they had been involved in the reviews. For example, people had access to health care professionals such as the GP, dentist, optician and district nurse. This meant that people were supported to keep healthy and well.

Is the service caring?

People told us that care staff spoke to them in a kind and respectful manner. One person said, 'The staff are OK. I get on well with them'. All members of staff spoken with were knowledgeable about people's care needs including their preferences and personal histories. We observed that people were listened to and care staff responded to them in a positive and caring way. One relative said, 'I feel X receives excellent care'.

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when they supported people. People told us, 'Staff always helps me, and they listen to what I have to say.' People told us that the staff were very, very good.

Is the service responsive?

The people we spoke with told us they were supported to express their views and be actively involved in making decisions about their care, treatment and support. In the care plans we looked at, we saw evidence which reflected that people and their relatives were involved in making their views known about how they wished to be cared for and supported. If people were not able to sign their care plans these were signed by family members. We saw evidence that regular care plan reviews took place. This meant that people's care needs were kept under regular review.

We found the service had received two complaints during the last year which had been dealt with to the satisfaction of the complainants. People we spoke with said they knew how to make a complaint, and had done so in the past. A relative of a person who used the service told us they discussed their relative's care needs with the manager in the past and more recently with the provider who has worked well with them to sort out issues concerning the care of their relative.

Is the service well led?

Staff spoken with said that they had felt supported by the registered manager until about six months ago. Now they feel supported by the provider. Staff meetings had recommenced and they were able to raise questions related to the delivery and implementation of best practice. This meant that staff felt supported and well-led.

Staff spoken with said that they were provided with adequate training. This enabled them to perform their roles and to be accountable for their actions.

People spoken with told us normally the manager was always available in the home. They said, 'The manager spoke daily with us to check if we were happy with the care and if the care workers were performing satisfactorily'. The member of staff said, 'However, this had changed since last month when the manager went off. The senior carers are here every day and we carry on as we had been doing'.

People told us they liked living at the home and they looked happy and relaxed in the presence of staff. One person told us that the 'staff are really nice' and another person told us that the 'staff are great'. People told us that they had just returned from a holiday in Spain.

The home is split between two houses with eight people living in the Walton Cottage and 10 people living in The Grange. We looked around the buildings which were clean, comfortably furnished and free from unpleasant odours. One person was happy to show us their room which was personalised with photographs, books, TV's and pictures.

During our visit we spoke with five people who used the service. We also spoke with four staff including the registered manager. We spent time observing how staff interacted and supported people. We saw staff treated people in a sensitive, respectful and professional manner.

People who used the service were very positive and were unanimous in agreeing that they were treated with respect. Each person commented that they were happy to live at The Grange and Walton Cottage. One person said 'It's really good here.'

People we spoke with told us that they had good relationships with staff and said they 'felt safe' at the home. People made positive comments about staff. One person told us that staff had taken people on a holiday abroad this year and we were told that it was 'the best holiday ever.'

People told us that they felt safe in the home and were able to talk to staff if they had concerns.

They told us that they felt involved in the decision making in the home. We saw that people participated in regular pictorial newsletters which they shared with their families and friends.