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Archived: Capwell Grange Care Home Good

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Reports


Inspection carried out on 9 November 2016

During a routine inspection

This unannounced inspection took place when we visited the service on 9 and 11 November 2016. It was completed on 23 November 2016 when we had received feedback from all members of the inspection team.

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.

Inspection carried out on 23 and 24 October 2014

During a routine inspection

We carried out this inspection on 23 and 24 October 2014, and it was unannounced.

Capwell Grange Nursing Home provides accommodation, care and treatment for up to 146 people who require nursing and personal care. The service consists of five purpose built single-storey units. Older people were supported in four units and the fifth unit was for younger adults. At the time of the inspection, there were 141 people being supported by the service, some of whom were living with dementia, mental health issues and physical disabilities.

At the last inspection on 29 and 30 May 2014, we had told the provider to make improvements to ensure that people were cared for in a safe, clean and hygienic environment, and improve how they assessed and monitored the quality of the service provided.

The service is required to have 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. At the time of our inspection, there was a manager in post and they had commenced the process to register with the Care Quality Commission.

People had risk assessments in place that gave guidance to the staff on how risks could be minimised. There were systems in place to safeguard people from the risk of abuse.

The home was clean and hygienic.

People’s privacy was protected, but people had not always been asked if they wanted to keep their bedroom doors opened.

The provider had effective recruitment processes in place and there were enough staff to support people. People’s needs had been met in a timely manner to promote their independence and dignity.

The manager and the nurses were aware of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). However, some of the care workers knowledge was limited and the provider had already recognised this shortfall in knowledge.

Medicines were managed safely. People were supported to have sufficient food and drinks by caring and compassionate staff.

People’s needs had been assessed, and care plans took account of people’s individual care and treatment needs, preferences, and choices. People were supported to take part in recreational activities they enjoyed.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people and acted on the comments received to enable them to improve the quality of the service.

Inspection carried out on 29, 30 May 2014

During a routine inspection

When we visited Capwell Grange Nursing Home on the 29 and 30 May 2014, we gathered evidence to help us answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

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.

Inspection carried out on 16 December 2013

During a routine inspection

During our inspection of Capwell Grange, we used a number of different methods to help us understand the experiences of people using the service. This was because some of the people using the service had complex needs, which meant they were not able to talk with us about their experiences. In addition we spoke with 16 people using the service and four relatives of people who use the service. People told us they were happy with the care and support they received from staff.

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.

Inspection carried out on 6 March 2013

During a routine inspection

Our inspection of 07 February 2013 identified areas of non compliance in relation to incomplete care records and the safety and suitability of the premises.

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.

Inspection carried out on 7 February 2013

During a routine inspection

During our inspection on 07 February 2013, we spoke with six people using the service, four visiting relatives and seven staff currently working at the service. In the two dementia units we used a number of different methods to help us understand the experiences of people using the service because some people using the service had complex needs which meant they were not able to tell us their experiences. Interactions between people using the service and staff were positive and respectful. We observed that people were offered support at a level which encouraged independence and assured their individual needs were met.

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.

Inspection carried out on 23 November 2011

During a routine inspection

On 22 November 2011 we visited Capwell Grange Nursing Home from 08.30 am. We spent the majority of our time on one of the five units speaking to people, observing how care was provided and looking at individual�s documentation. People told us that they were able to make choices about their daily routines such as when they got up, what they did with their day and what they had to eat. One person said, �the food is nice and if I don�t like something they find me something I do like�. We observed that the care staff spoke appropriately to people and in a manner that confirmed that they understood the individuals need. When the staff carried out tasks and were talking to the people using the service, they sat with them and did not rush them.

People told us that they were well cared for. One person said, �I have been here three years and I trust them to look after me�.

People with whom we spoke told us that they felt safe in the home, One person said, �the staff are so kind they look after all us old folk so well�. A visitor who told us she visited her husband every day also told us that she would report to the home manager, or the authorities, if she witnessed anything untoward.

People told us that the staff were good and responded to them when they asked. A visitor said, �the staff are so friendly they make me so welcome�.

Reports under our old system of regulation (including those from before CQC was created)