Archived: Grange Court

This was the first inspection for Grange Court since the service was registered with us.  The inspection took place on 23 and 24 September 2015 and was unannounced. The people living at the home were on the autistic spectrum. At the time of the inspection there were three people living permanently in the home and another person involved in the admissions process. Not all the people living at Grange Court were verbally able to give us their feedback on their experiences of the care and treatment delivered by the staff. A member of staff during the introduction to the inspection advised us that two people at the home were not able to express their experience of the service. They said one person was able to give feedback with support.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were not always protected from inappropriate care and treatment as records were not always accurate or up to date.

People were placed at risk of potential harm. Risk assessments and strategies were not up to date or reviewed following aggressive and physically challenging incidents. This meant the management of behaviours was not assessed to ensure staff consistently managed aggression and physically challenging incidents. Reports of incidents and accidents were developed following an event and or analysed to identify patterns and trends.

Care plans were not updated and for some people the plans related to their previous placement. Care plans did not detail the strategies used to encourage people to participate in activities.

People were placed at risk from staff who were not able to manage high levels of physically challenging and aggressive incidents. A member of staff said that at the PBM training they were taught about personal space but not how to protect themselves when they were physically attacked or when protective personal equipment was removed. This meant staff were not following guidance because they became anxious of people becoming aggressive or physically challenging.

People were not having their prescribed “when required” medicines administered consistently. Protocols which gave staff direction and guidance on when to administer these medicines were not in place.

One person said they felt safe and they would tell staff if they were not happy. Members of staff knew the signs of abuse and the expectations placed on them to report their suspicions of abuse.

People were supported by sufficient numbers of staff. Rotas were arranged for people to have the appropriate level of support. For some people three staff were appointed to support them throughout the day. People had their care and treatment delivered by a core team of staff that knew their preferences, their likes and their dislikes. Staff were working to improve the range of community activities some people could experience. One person was able to give us some feedback. They told us the activities they did and the staff who supported them with these activities.

Arrangements were in place for people to maintain contact with relatives and friends. For example, review meetings, weekly updates, newsletters and forums

Quality assurance arrangements were in place to monitor the standards of care. Action plans were developed where standards were not fully met. People’s views were sought through surveys and during care plan review.

Staff said morale was good since structures were strengthened and the area manager was appointed. The manager told us of the learning that happened and about the improvements needed to develop standards and systems.

We made recommendations for the service to seek advice and guidance from a reputable source, about motivators and rewards.

We found breaches of the Health and Social Care Act 2008(Regulated Activities) Regulation 2014. You can see what action we told the provider to take at the back of the full version of the report.