Archived: Capwell Grange Care Home

The service provides care and nursing support to people with a variety of needs including those living with dementia, physical disabilities, mental health needs and chronic health conditions. On the day of our inspection, there were 142 people being supported by the service.

There was a registered manager in post. 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.

Potential risks to people’s health, safety and welfare had been reduced because there were risk assessments in place that gave guidance to staff on how to support people safely. There were systems in place to safeguard people from avoidable harm and staff had been trained in safeguarding procedures. The provider had effective recruitment processes in place and there was sufficient staff to support people safely. People’s medicines were managed safely.

Staff had regular supervision and they had been trained to meet people’s individual needs. They understood their roles and responsibilities to seek people’s consent prior to care and support being provided. The requirements of the Mental Capacity Act 2005 (MCA) and the related Deprivation of Liberty Safeguards (DoLS) were being met.

People were supported by staff who were kind, caring, friendly and respectful. They were supported to make choices about how they lived their lives and how they wanted to be supported. People had enough to eat and drink to maintain their health and wellbeing. They were supported to access other health services when required.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Where possible, people and their relatives had been involved in reviewing people’s care plans. People had been provided with a variety of activities facilitated by activities coordinators on each unit.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service, their relatives, external professionals and staff, and they acted on the comments received to continually improve the quality of the service.

The provider’s quality monitoring processes had been used effectively to drive continuous improvements. The manager provided stable leadership and effective support to staff, and promoted a caring and inclusive culture within the service. Staff were motivated to do their best to provide good care to people who used the service and to work in collaboration with people’s relatives.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

People spoken with said that they felt safe living at Capwell Grange Nursing home. We found that the home had processes in place to protect people from abuse or the risk of abuse.

We found that the home had arrangements in place to ensure that people who use the service were safe and that their health and welfare needs were met. This was because there were enough skilled and experienced staff to meet their needs.

Steps had not been taken to provide an environment that was safe and adequately maintained. Areas of the premises were showing signs of wear and tear in respect of fabrics, furnishing and d'cor.

The system the home had in place to provide and maintain a clean and appropriate environment to prevent and control the spread of infection was not effective. Areas of the premises were not appropriately cleaned and best practice guidelines were not followed. For example, people who needed to be hoisted regularly were sharing slings.

Is the service effective?

We found that people were given choices around what they wished to eat and drink and when to rise and retire. Staff enabled people to maintain their independence for as long as possible.

People's needs had been assessed prior to using the service. This enabled staff to develop appropriate and effective plans of care.

The home had systems in place to monitor people's health care needs in conjunction with relevant external health care professionals. People's weights, nutritional intake and pain management were regularly monitored. This ensured that people's welfare and well-being were appropriately promoted.

Is the service caring?

Staff provided activities to people that were age appropriate. For example, people responded to the music that they were listening to. Overall we found that staff assisted people with their personal care in an unrushed and caring manner.

Staff spoken with were clear about the needs of the people they were caring for and were able to describe their care needs as reflected in their care records.

Is the service responsive?

The home had a system in place to ensure that complaints were appropriately addressed. We found that people's complaints were responded to and used to improve on the quality of the care provided.

In one particular unit we found that staff recognised and supported the reality of the people they were caring for by providing them with an outdoor area with chickens, flower beds, bus feature and a bench for them to enjoy.

The provider's monitoring system was not fully responsive and effective. This was because it had not identify the area of concern that we found during our inspection in relation to the cleanliness of the environment.

Is the service well led?

Staff spoken with said that they felt supported by the registered manager and were able to make suggestions and raise concerns without fear. We found that residents and relatives meetings were regularly facilitated. People and their relatives were asked to complete annual surveys. This enabled them to comment on the quality of the care provided.

We saw that each person received an assessment of their care needs, including any risks associated with their care provision. Records showed that people and their families had been involved in the development of their care plans.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

We looked at the systems in place for cleanliness and infection control. We found that some areas required improvements to reduce the risk and spread of infection. We found the premises were maintained to ensure the home remained safe for people using the service, staff and visitors.

We saw the service had effective systems to regularly assess and monitor the quality of service that people received. These included surveys, audits and an effective complaints procedure.

We completed a follow up visit on 06 March 2013 to review improvements to the service. We did not talk to people who used the service during this visit. We found that the assessment process was robust and care records for people using the service were fully completed.

We reviewed the environment in nursing units where previously areas of non compliance had been identified and in the administration unit where people using the service visited the hairdressing salon. We found that all areas indentified at the previous visit had been either completed or that plans were in place for work to commence.

People told us they were happy with the care and support they received from staff. One person told us they were 'finding it very comfortable. Staff are very helpful and I feel better now I'm here.'

We noted that some areas of the service were in need of attention, for example, fire exit doors had been taped over in one unit and there were raised and loose paving slabs around the site which presented a potential risk hazard.

We saw that the recruitment process was robust and people were cared for by suitably qualified, skilled and experienced staff.

There was an effective complaints system in place. Comments and complaints people made were responded to appropriately and in a timely manner.