16 January 2018
During a routine inspection
Grafton Lodge is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Grafton Lodge provides accommodation and support for up to 22 older people. There were 16 people living at the service at the time of our inspection. People had varying care needs. Some people were living with dementia, some people had diabetes, some people required support with their mobility around the home and others were able to walk independently. One person was cared for in bed due to deterioration in their health.
The service was in a detached well maintained building in a residential area. A pleasant private garden was available for people to sit out in when the weather was fine. Bedrooms were on the ground and first floors. A passenger lift was available between floors so people could access any part of the building if they wished.
At the last inspection on 8 December 2015 the service was rated Good. At this inspection, we found the service remained Good.
A registered manager was employed at the service and had been in the position since the last inspection. The registered manager was also one of the providers. 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. A new manager had recently been appointed who would be applying for registration with CQC when the registered manager took a different role in the service.
Staff continued to be aware of their responsibilities in keeping people safe and reporting any suspicions of abuse. Staff knew what the reporting procedures were and were confident their concerns would be listened to.
Individual risks were identified and steps continued to be taken to reduce and control risk. Staff had the guidance they needed to support people to maintain their independence while at the same time preventing harm. Accidents and incidents were recorded by staff, action was taken and followed up by the registered manager.
The processes for the administration of people’s prescribed medicines was still managed and recorded well so people received their medicines as intended. Regular audits of medicines were undertaken to ensure safe procedures were followed and action was taken when errors were made.
The registered manager and deputy manager continued to undertake a comprehensive initial assessment with people before they moved in to the service which fully included the involvement of the person and their relatives where appropriate. Care plans were developed and regularly updated and reviewed to take into account people’s changing needs. People’s specific needs were taken account of and addressed in care planning to ensure equality of access to services.
People were supported to make their own choices and decisions whenever possible. The registered manager and staff continued to have a good understanding of the basic principles of the Mental Capacity Act 2005 (MCA) and promoted people’s rights.
Food was home cooked with plenty of variety and choice at mealtimes. People told us they had access to plenty of drinks throughout the day. People’s specific dietary needs were known about and catered for.
People were supported to gain access to health care professionals when they needed advice or treatment. The registered manager had developed good relationships with local health care professionals and referred people as soon as they needed.
People had access to activities of their choice. Some people preferred their own company and pursued their own interests such as reading, watching TV or puzzles and this was respected by staff. People were asked their views of the service and action was taken to make improvements where necessary.
There continued to be clear evidence of the caring approach of staff. People and their relatives were positive about the staff who supported them, describing them as caring and saying they were confident in the care they received. Staff knew people well and were able to respond to their needs on an individual basis.
Suitable numbers of staff were available to provide the care and support individual people were assessed as requiring. The provider continued to make sure safe recruitment practices were followed so only suitable staff were employed to work with people who required care and support.
Staff were still supported well by the management team. Staff told us they were approachable and listened to their views and suggestions. Training was up to date and staff were encouraged to pursue their personal development. Staff continued to have the opportunity to take part in one to one supervision meetings to support their success in their role. Regular staff meetings were held to aid communication within the team and to provide updates and feedback.
Quality auditing processes were in place to check the safety and quality of the service provided. Action was taken where improvements were observed.
People and their relatives thought the service was well run, people knew the registered manager well and were very happy with the service provided.
Further information is in the detailed findings below.