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Inspection carried out on 8 May 2019

During a routine inspection

About the service:

Grangemoor House Nursing Home is a residential care home that provides personal and nursing care for up to 30 people who have a mental health condition. The accommodation is provided in a single building, arranged over two floors, with communal facilities including dining rooms and lounges on both floors. At the time of our inspection, 17 people were using the service.

People’s experience of using this service:

People felt safe and were protected from the risk of harm by staff who understood their responsibilities to identify and report any signs of potential abuse. We found that any concerns were taken seriously and investigated thoroughly to ensure lessons were learnt.

Risks associated with people’s care and support were managed safely. People received their prescribed medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. There were sufficient, suitably recruited staff to meet people’s needs.

The service worked in partnership with other organisations and health and social care professionals were positive about the care and support people received. Staff received training and ongoing support to meet people’s individual needs. People were supported to have a varied and healthy diet and to access other professionals to maintain good health.

Staff knew people well and promoted their dignity and independence at all times. There was a kind and caring, inclusive atmosphere. Staff had good relationships with people and ensured people's friends and families were made welcome at the service. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service underpin this practice.

People’s support plans reflected their needs and preferences and were reviewed when things changed. People’s diversity was recognised and promoted by the staff and systems were in place to meet people’s communication needs. There was a strong emphasis on supporting people to take part in activities, follow their religious beliefs and maintain their cultural identity. Arrangements were in place to ensure people’s end of life wishes were explored and respected.

The provider used management systems to identify and effectively manage risks to the quality of the service and drive continuous improvement. People and their relatives knew how to raise any concerns or complaints and felt confident they would be acted on. There were systems in place to capture people’s views on how the service could be improved and these were acted on. Staff felt supported and valued by the management team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (report published 16 November 2016).

Why we inspected:

At the last inspection the service was rated Good overall, with Requires Improvement in the Well-led domain. This was because improvements were needed to the quality assurance systems to continually drive improvements. At this inspection, we found the provider had addressed the concerns identified and the service was rated as Good in each domain.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 20 October 2016

During a routine inspection

This inspection visit was unannounced and took place on 20 October 2016. At our last inspection on 13 August 2015 we asked the provider to make improvements across all aspects of the service we inspected. At this inspection, we found improvements had been made to most areas. The service was registered to provide accommodation for up to 30 people. People who used the service had mental health conditions. At the time of our inspection 27 people were using the service.

The service did not have a registered manager, however the provider had recruited a new manager and we met with them during the inspection. Our records show they were progressing with their application.

The service had systems in place for auditing the quality of the care; however these were still being developed and had not yet reflected any trends to consider on going improvements in all areas of the service. People, relatives and professionals had not been consulted on their experience of the service to consider areas of development. Staff felt supported, however written formal meetings had not been recorded to ensure people’s individual development for their role was considered.

People felt safe in the service and the staff knew how to respond to incidents to protect people from the risk of abuse. There was sufficient staff available to support people’s needs throughout the day and night. New staff received the training and support hey required to ensure they were able to feel confident in their role.

The staff had received a wide range of training which provided them with the appropriate knowledge and skills to provide safe and individualised care. Medicines were administered and stored safely to support people’s requirements around pain relief and medical conditions.

People were supported to make decisions and when they lacked capacity to make certain decisions, this was done in their best interests. When required authorisation to deprive a person of their liberty was given by the local authority and any guidance from the authorisation was followed. This ensured people were safe but supported to have individual choices in some areas of their lives.

People were provided with choices to meet their nutritional needs. When additional support with meals was required we saw specialist diets had been catered for. People told us staff had developed a positive relationship with them. Individuals were treated with dignity and respect and had their choices acted on. There was a positive approach to activities and this was an area of development within the service. People knew how to complain and there was a process in place to respond efficiently to resolve any concerns.

Inspection carried out on 13 August 2015

During a routine inspection

This inspection took place on 13 August 2015 and was unannounced. Grangemoor House Nursing Home provides personal care and support for up to 30 people with mental health conditions. At the time of this inspection 30 people used the service. The last inspection was completed in December 2013 and was compliant with the Regulations we looked at.

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.

Some people who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) were being followed. People were not always involved in making decisions about some restrictions and restrictive practices that were placed on them.

People told us the staff were pleasant and supportive but there were times when people had to wait for staff to be available to support them.

Risks to people’s health and wellbeing were not consistently identified, managed and reviewed. Some people were subject to regular checks of their whereabouts, there were no assessments to determine if these checks were necessary for each individual person.

People told us they liked the food but at times a change in menu would be beneficial.

People had access to healthcare professionals but some people experienced occasional delays with routine appointments.

People told us they liked living at the home and were satisfied with the environment and staff. However, some working practices did not support people with maintaining or developing their independence.

The provider had a complaints procedure and people told us they would speak with the registered manager or staff if they had concerns.

Systems were in place to assess the quality and safety of the home.

Inspection carried out on 9 December 2013

During a routine inspection

We visited Grangemoor House nursing home on an unannounced inspection which meant that the provider did not know we were coming. We found that there were 28 people living in the home. We spoke with four people who used the service, the registered manager and two staff.

Some people who used the service were not able to speak with us due their health conditions. One person we spoke with said: “I like it here. I have to go to hospital today for an appointment. The staff sort that out for me”. Another person told us: “I go out every day. I like to go to the shops”.

We checked three care plans and found that people’s care needs and risk assessments were reviewed regularly. This meant that people received care and support that met their current needs.

We saw that systems were in place to ensure that medication was administered in a safe way. We found that the staff were trained and supported to meet the needs of the people who used the service.

We found there was a system in place to deal with comments and complaints for the benefit of the people who used the service.

Inspection carried out on 25 January 2013

During a routine inspection

We visited Grangemoor nursing home on an unannounced inspection which meant that the provider did not know we were coming.

People were able to express their views and these were taken into account in the way the service was provided. People who used the service told us, “I like it here – I’m happy”.

People had an assessment of their needs which included all aspects of daily living.

People were protected from abuse and staff understood the signs of abuse and how to report any suspicions of abuse.

The provider of the service notified the Care Quality Commission about any deaths that occurred within the service so that, where needed, action could be taken.

People who used the service could be confident that important events that affected their welfare, health and safety were reported to the Care Quality Commission so that, where needed, action could be taken.