Harton Grange is registered to provide accommodation for up to 61 persons who require personal care, some of whom may have dementia. It is a purpose built building with two floors of accommodation which are served by a passenger lift. The home has a balcony sitting out area and a safe, secure garden area. The home is situated in a residential area in South Shields, close to shops, amenities and public transport. At the time of our inspection, there were 60 people using the service.
This inspection took place over two days. The first visit on 16 December 2014 was unannounced which meant the provider and staff did not know we were coming. Another visit was made on 17 December 2014.
The last inspection of this home was carried out on 23 December 2013. The service met the regulations we inspected against at that time.
The service had a 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 at Harton Grange. They told us, “I feel really safe sleeping here. I don’t feel worried about anything” and “It’s lovely here. It’s the people; the way we all work and play together.” Relatives also considered the home to be a very safe place for their family members. One commented, “It’s lovely. I’ve got no worries. The girls are lovely. (My relative) is relaxed. I come every day. She is never upset when I go. They’re marvellous; from the handyman, the manager, and the catering staff – all of them. Safe, I couldn’t have picked a better place.”
The staff identified potential areas of risk in respect of people’s care, such as the risk of falls and skin damage, and took steps to reduce the likelihood of people being harmed by such risks occurring.
There were sufficient numbers of suitable staff to keep people safe and meet their needs. Staff carried out their duties in a thorough and calm way. Relatives told us, “I’m sometimes surprised at the number of staff. There always seems to be plenty of staff,” and “Yes, there is usually enough staff. We’ve never felt it’s inadequate or the staff are not coping.” We found there were thorough recruitment procedures in place. This helped to protect people as checks had been carried out on potential staff before a decision was made to employ them.
People’s medicines were managed safely. Staff followed safe procedures which helped ensure people’s medicines were stored correctly, ordered in time and given to them when they needed them. Relatives we spoke with were confident their family members received the help they needed with medicines. One commented, “She gets her pills at the right time. She had conjunctivitis last week; they’ve been putting eye drops in and its cleared up.”
Staff told us they felt supported by the provider, by way of training, supervision and appraisal. This helped them provide effective care for people. People and their relatives were confident the staff team had the skills needed to care for people well. Similar views were also expressed by health and social care professionals who regularly visited the home. Their views included, “Staff are excellent and very caring,” and “Their communication skills are excellent.”
Staff sought people’s consent before they provided care to them. Staff followed the requirements of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS).
Comments from people, their relatives and dietetic professionals showed that the service provided effective support to people to provide them with good nutrition and hydration. Relatives told us, “The food is very good. There is always a choice. They keep an eye on (our family member’s) weight and fluids. She finishes her meal every day.” Another relative said, “My relative had put a bit of weight on, the last time she was weighed. She loves her grub.” A health professional said, “The cooks have an excellent understanding of nutrition needs and we’ve seen a 70%-80% decrease in the reliance on nutritional supplements, directly through the high standards of catering provided here.”
People were supported with their health care needs and prompt referrals were made for medical assistance when needed. A member of the community nursing team who regularly visited the service told us, “We work very closely with Harton Grange. We have no concerns from the past or present. They follow care plans. Their palliative care is very good. We work through any issues together.”
Staff had developed positive, caring relationships with people using the service. Relatives of people who used the service were confident that the staff team were caring and kind. Their comments included, “It’s brilliant,” and “Staff genuinely care.”
Staff showed people respect and dignity and safeguarded their privacy. Staff were able to spend time with people in meaningful tasks and conversations which meant people felt supported and cared for.
People received personalised care that was responsive to their needs. The service provided skilled and stimulating care for people with dementia conditions. The registered manager and staff had put considerable thought and attention into creating an environment which provided safe opportunities for people to keep busy, get involved in interesting activities or just spend time with staff and other people in a convivial atmosphere. Relatives and health care professionals we spoke with praised the positive impact this had made to people. A relative told us, “The change in my relative is unbelievable. They are doing crafts and she is going on trips. She was stuck in a rut. It is like she has gone to being fifty or sixty. The staff are amazing.”
People had no complaints about their care and were confident any issues would be dealt with appropriately. People were encouraged to share their views about the service and these were acted on. For instance, people were able to influence the decoration of the communal areas of the home and had been involved in the decoration of their own bedrooms.
The service was managed well and the registered manager ensured good quality and consistent care. This was reflected in the comments we received from a number of other professionals who had contact with the service. For instance, a local authority care manager told us, “The registered manager is lovely. She is fantastic as a manager. She has drive, enthusiasm and commitment. She is not a pushover; if there is a problem, she is onto it straight away.” Relatives of people who used the service were also impressed by the way the service was managed. One relative commented, “(The registered manager) is great. You only have to step in the home and it is always lovely. She is always on the ball and she watches the staff without being bossy. She has a good sense of humour. She keeps on top of her job.”