We carried out a review of the data available to us about The Angela Grace Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Angela Grace Care Centre, you can give feedback on this service.
We found the following examples of good practice.
All staff received infection prevention and control (IPC) training and had their competencies assessed regarding donning and doffing and hand hygiene. All staff wore uniforms and changed before and after each shift at the service.
The registered manager completed regular IPC audits to maintain oversight and ensure correct procedures were in place and being completed. Spot checks were completed by the management team to ensure IPC guidelines were followed at all times.
There were systems and processes in place to ensure people, staff and visitors were screened and tested for COVID-19 regularly to reduce the spread of COVID-19. The registered manager supported people to self-isolate as required and zoned staff when the service was in an COVID-19 outbreak.
Cleaning schedules were in place for all areas of the home. The home appeared clean with no odours.
Risk assessments were in place for people and staff regarding individual risk factors of COVID-19.
We found the following examples of good practice.
¿ The service was clean and tidy. Regular cleaning took place throughout the service including touchpoint areas.
¿ Suitable arrangements were in place to ensure that anyone moving into the service, did so safely. This included a negative COVID-19 test before moving in and isolating for a 14-day period within the service.
¿ Staff had access to sufficient supplies of personal protective equipment (PPE) including masks, gloves, aprons and hand sanitiser. We observed staff using PPE correctly.
¿ Staff followed guidelines with the donning and doffing of PPE and had an area within the service where this could be done safely.
¿ Regular testing was completed for staff and people living at the service. This meant prompt action could be taken should anyone test positive for COVID-19.
¿ Safe arrangements were in place for visitors to the service including health professionals and relatives when it was safe to do so. This included LFD (lateral flow device) rapid testing, temperature checks, hand sanitisation, PPE and a questionnaire.
¿ Regular checks and audits around infection control were completed to ensure the registered manager had oversight of the service and could address any issues promptly if found.
¿ There were multiple dining and communal areas around the service for people to use. Staff had a separate room to take their breaks in. These measures assisted with social distancing and helped keep everyone safe.
Angela Grace Care Centre is a residential care home that can provide residential care for up to 78 older people including people living with dementia, physical disabilities, complex health needs and sensory impairments. At the time of inspection 75 people were using the service
People’s experience of using this service:
Not everyone we spoke to, felt there were enough staff on duty to complete person-centred care. However, the registered manager had completed a dependency tool to ensure there were enough staff to meet the needs of people supported by the service and we saw evidence that people’s call bells were responded to quickly.
Staff were confident in their roles and the training provided covered all areas of their jobs.
People told us they felt safe and that staff were caring, approachable, polite and friendly.
Risks associated with people had been assessed and recorded and people’s care needs were assessed before they moved into the service, to ensure that effective care could be delivered to them.
Care plans detailed people’s preferences as to how they liked their care to be delivered and included likes and dislikes, and how they wished the staff to communicate with them. Staff we spoke with had a good knowledge and understanding of the people using the service and people and relatives told us they were involved in their care planning. People had signed consent forms for care to be delivered.
Staff were aware when people had dietary concerns and supported people to have those needs met. People told us the food was good.
Staff were aware of good practice and guidance in end of life care, and respected people's personal, cultural and religious beliefs and preferences.
We checked whether the service was working within the principles of the Mental Capacity Act, whether any restrictions on people’s liberty had been authorised and whether any conditions on such authorisations were being met and found that they were.
The provider had effective safeguarding and whistleblowing systems and policies in place. The provider followed safe staff recruitment procedures and medicines were managed safely.
People told us staff respected their privacy and dignity. A person told us, “Staff always tell you what they are doing and ask permission before doing anything.”
Family members and friends were made welcome when they visited the service and were offered refreshments. Visitors could join their family member or friend for a meal.
Complaints procedures were in place for people to let staff know if they were unhappy with any aspect of the service. Complaints information was displayed on the notice boards.
Planned reviews of people’s care were monitored to ensure they took place and that care plans or risk assessments were updated where needed.
The provider arranged regular family, resident and staff meetings.
The registered manager had a number of quality assurance systems in place. Audits were in place which enabled the management team to monitor the service and drive improvements as required.
The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.
More information is in the full report.
Rating at last inspection:
At the last inspection the service was rated Good. (Report published 17 October 2016)
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We will continue to monitor this service and plan to inspect in line with our reinspection schedule for services rated Good. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
There was not a registered manager in post, however an application had been received by the Care Quality Commission (CQC) and this was being assessed at the time of the inspection. 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.
Improvements were required to ensure the staff adequately monitored people’s nutritional needs. Staff regularly reviewed the nutritional support people required however this was not always accurate or fully analysed. People were supported and encouraged to eat well and maintain a balanced diet.
People felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There were sufficient staff to meet the needs of the people and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.
Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.
People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.
People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).
Care plans were written in a person centred manner and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.
The manager had a number of systems in place to monitor the quality of the service. People at the home reacted positively to the manager and the culture within the home focussed upon supporting people’s health and well-being and for people to participate in activities that enhanced their quality of life. Systems were in place for the home to receive and act on feedback which reflected the care provided at the home.
This unannounced inspection took place on 23, 26 and 30 November 2015 and 10 February 2016. The Angela Grace Care Centre provides accommodation for up to 72 people who require nursing or residential care for a range of personal care needs. The home has four floors, one of which was not in use. One floor was dedicated to people requiring assessment following discharge from hospital. The other two floors had people who required nursing or residential care, for dementia or other enduring mental health conditions or they were admitted specifically for end of life care. At the time of our inspection there were 51 people living at the home.
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.
Systems to monitor the effectiveness of some aspects of care had not been implemented, leading to inconsistent staff practices of recording and sharing information about people’s care. People did not always receive their planned care to prevent pressure ulcers.
People were safeguarded from harm as the provider had systems in place to prevent, recognise and report any suspected signs of abuse. Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately. People had access to an advocacy service.
There were sufficient numbers of experienced staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job. Staff received training in areas that enabled them to understand and meet the care needs of each person.
People’s care and support needs were reviewed and updated as people’s needs changed. People had been involved in planning and reviewing their care when they wanted to.
People were supported to have sufficient to eat and drink to maintain a balanced diet. Staff monitored people’s health and well-being and ensured people had access to healthcare professionals when required. There were appropriate arrangements in place for the management of medicines.
Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. People experienced caring relationships as staff had taken time to build therapeutic relationships with them. People’s dignity and right to privacy was protected by staff.
People were supported to carry out their wishes about their care at the end of their life. Nursing staff were experienced in carrying out assessments and providing care that met people’s end of life needs and accessed the community end of life care team for additional support.
The Registered Manager provided staff, residents and relatives with opportunities to discuss the improvements and changes in the home. People had provided positive feedback about their experiences in the home. People had their comments and complaints listened to and acted on.
We identified that the provider was in breach of two of the Regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 (Part 3) and you can see at the end of this report the action we have asked them to take.