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Inspection carried out on 18 July 2018

During a routine inspection

This was an unannounced inspection that took place on 18 July 2018 with a short follow up visit on 30 July 2018. The service was last inspected in March 2016 where there were no breaches in regulation seen and the home was rated as Good.

Gregory House 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.

The original company who owned this service was bought out by Elysium, who are now the registered provider.

The care home accommodates up to 24 people across four separate units, each of which have separate adapted facilities. One of the units was being used for respite care purposes when we visited. There were 17 people in residence when we visited. People living in the service may have a learning disability and/or are living with mental illness. Where people are in the home for long periods of time they are assessed as being in need of specialist nursing care to support them. The service supports people to move on to more independent living, where possible.

The home has been open since 2015 and was purpose built to accommodate people in a 'group living' setting. Each of the four units has six bed rooms with ensuite shower and toilet, a shared bathroom with adapted bathing facilities, a lounge area, dining area and a fully equipped kitchen. Some bedrooms have 'anti-barricade' adaptations and there are other specialised adaptions to support people who may have issues managing behaviours and emotions. Each unit has its own secure garden. The unit is in a residential area of Workington and is in walking distance of local shops. People are supported to access public transport to get out an about into Workington and beyond.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The home has a suitably qualified and experienced registered manager who has both a nursing and social care background. 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.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been suitably vetted and that they were the right kind of people to work with vulnerable adults. Accidents or incidents management was of a good standard.

The registered manager and her senior team kept staffing rosters under review as people's needs changed. Staffing reflected the numbers of people in respite and any issues individuals needed more support with. We judged that there were suitable professionals employed and sufficient care and support staffing levels in place by day and night. There were suitable numbers of ancillary staff employed in the home.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles. Nursing staff told us they were given time and opportunity to keep their practice up to date.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. Any issues were dealt with promp

Inspection carried out on 10 March 2016

During a routine inspection

This was an unannounced inspection on 10 March 2016.

Gregory House is a modern, purpose built nursing home specialising in the care of people living with a learning disability or a mental health problem. Accommodation is in single, ensuite rooms. The home can take up to 24 people in four units of six bedrooms. Each unit has a small kitchen and lounge and dining areas. There are some shared areas that can be used for activities and meetings. There is suitable outside space in the secure garden. The home is situated in a residential area of Workington and is near to local shops and good transport links.

The home has 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.

People in the service were protected from harm and abuse because suitable arrangements were in place to safeguard them.

The premises and the working practices in the home ensured that people in the home and the staff team were as safe as possible at all times.

Accidents and incidents were carefully monitored and risk management plans were in place.

The home was staffed with a mix of experienced and suitably qualified staff who could meet the needs of people in the home. Staffing levels were suitable for the needs of people in the home.

Staff were recruited appropriately. The service had policies and procedures related to disciplinary and grievance matters.

Medicines were well managed in the service. Individuals had regular medicines' reviews and the nursing staff monitored any side-effects of medicines.

The house was clean and orderly with good infection control measures in place.

Staff in the service were suitably trained. Staff received training in basic skills and in the specialist skills used in the home. Nurse training was on-going.

Supervision, both formal and ad hoc, had commenced. Staff competence was being checked on and appraisals planned.

The staff team had a good knowledge and understanding of relevant legislation. Where staff felt concerned about necessary restrictions they applied for a Deprivation of Liberty authority.

All staff in the home were trained in the management of behaviours that might challenge. Restraint was only used as a last resort but the staff team had received suitable training to do this.

People in the service were happy with the meals provided and some people enjoyed preparing meals for themselves.

Gregory House was a purpose-built home that had been open for less than a year. The design of the building allowed people to be safe in a homely setting.

We observed staff approach, we looked at training and we asked people about how staff treated them. We judged that this team had a caring, non-judgemental approach to care delivery that paid good attention to matters of equality and diversity.

People were encouraged to be as independent as possible because the long-term aim was to move people to more independent living.

Care files contained detailed risk assessments, person centred care plans, contingency plans and recovery plans. These were of a good standard and people told us that they had been involved in drawing these up.

People were encouraged to engage in activities both inside and out of the home. Plans were in place to support people back into education or to become more involved in the local community.

The service had suitable policies and procedures in place to deal with any concerns or complaints. There had been no concerns and no formal complaints made since the service opened.

We saw evidence to show that both admission and discharge were planned in a suitable way so that transition between services was managed well.

The home had a suitably qualified and experienced manager who was registered with th