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Inspection Summary


Overall summary & rating

Good

Updated 10 January 2019

This inspection took place on 20 and 26 November 2018. The first day of the inspection was unannounced.

The Grange is situated close to Selby town centre and is registered to provide residential care for up to 47 people some of whom may be living with a physical disability or dementia. The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 23 people lived at the service.

The service comprises of a large detached house with an additional unit called The Mews which originally supported people living with dementia. At the time of our inspection the main house was undergoing significant renovation work and everybody resided within The Mews.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staffing levels were safe. There was a registered manager and consistent team of care staff supported by a team of ancillary workers.

We have made a recommendation for the provider to review staffing levels on a weekend.

Agency staff were used to ensure safe staffing levels. Recruitment practices continued to be safe. Staff received safeguarding training and understood potential signs of abuse. Staff recorded accidents and incidents and these were monitored by the registered manager and provider. Risk assessments were completed for areas of identified risk. Staff understood the support people may require if they were distressed or anxious. Actions were taken to help control the spread of infection and to maintain the cleanliness of the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s consent was sought before providing care. There was plentiful access to food and drink throughout the day and people spoke positively about the meals. Staff undertook training and received regular supervisions and appraisals to support them in their role. People told us staff were skilled at their jobs. Efforts had been made to assist with people’s orientation around the service.

People said staff were kind and caring. Staff were patient and reassuring in their approach to people. Staff supported people to use their skills and promoted their independence. Information was available about how people communicated their needs and wishes and staff encouraged their decision making. People had access to advocacy support if they needed support to make decisions or to express their views.

Detailed and person-centred care plans were in place and these were reviewed. A timetable of activities was in place for people to participate in should they have wished to. Staff were mindful to ensure people were not socially isolated. People’s end of life wishes were documented if they had chosen to share this information.

The registered manager and provider completed a series of audits to monitor the quality and safety of the service provided to people. Staff told us they felt well supported and happy in their roles. Staff meetings were held and were an opportunity to discuss learning from the checks of the service. People’s feedback was sought on the running of the service. Statutory notifications had been sent appropriately to the Commission.

Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 10 January 2019

The service remains Good.

Effective

Good

Updated 10 January 2019

The service remains Good.

Caring

Good

Updated 10 January 2019

The service remains Good.

Responsive

Good

Updated 10 January 2019

The service remains Good.

Well-led

Good

Updated 10 January 2019

The service remains Good.