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 promptly and appropriately. This service did not rely on the use of strong sedatives and would ask for review from psychiatrists and specialist practitioners rather than use these strong medicines.
People in the home saw their GP and health specialists whenever necessary. Specialist nurses and psychiatrists kept people's care needs under review. The staff team had good working relationships with the local mental health team and with the learning disability team in the area.
Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.
People told us they were very happy with the food provided and we saw well prepared meals that people told us they enjoyed. We also noted that people could shop and cook for themselves if they wished. Nutritional planning was being developed further.
Gregory House is a purpose built home that was opened in 2015. It has suitable adaptations to ensure people were safe and had enough personal and shared space. The house was warm, clean and comfortable on the day we visited. Suitable equipment was available.
The staff team were aware of their responsibilities under the Mental Capacity Act 2005. Staff were also aware of their responsibilities when care was subject to mental health legislation. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People who lived in the home told us that the staff were caring. We also observed kind and patient support being provided. Staff supported people to understand the appropriate boundaries for living together with others. They made sure that confidentiality, privacy and dignity were maintained. Care planning reflected independence and skills building for many people who hoped to live more independently.
Risk assessments, person centred plans and care plans provided detailed guidance for staff in the home. People in the service were aware of their care plans and many had influenced the content. Where possible people set their own short and long term goals. The management team had ensured the plans reflected the person centred care and nursing that was being delivered.
Staff could access specialists if people needed communication tools. Many of the nursing staff had training and qualifications that would help them use specific communication strategies. Documents were available in an easy read format.
Staff took people out locally and encouraged people to follow their own interests and hobbies. On the day of our visit people went shopping and swimming. We saw evidence of people being encouraged to develop interests and activities as individuals with a view to living more independently.
The service had a comprehensive quality monitoring system in place and people were asked their views in a number of different ways. Quality assurance was used to support future planning.
We had evidence to show that the registered manager and the operations manager were able to deal with concerns or complaints appropriately .
Records were well organised, easy to access and stored securely. The original company who owned the home had been bought out by a new provider and the staff were in the process of assimilating some of their templates. This was being completed incrementally.