Archived: The Grand

Updated 9 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 14 January 2015. This was an unannounced inspection. The inspection team consisted of two inspectors, a specialist advisor, who was a nurse, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We received this information as requested. We also checked the information that we held about the service such as information we had received and statutory notifications. A notification is information about important events which the provider is required to send us by law. We contacted commissioners (who fund the care for some people) of the service and asked them for their views.

During the inspection we spoke with 10 people who used the service, seven relatives, three members of care staff, one nurse, the chef, an activities co-ordinator and three members of the management team. The manager was not available at the service on the day of our inspection. We observed care and support in communal areas. We looked at the care records of seven people who used the service, staff training and recruitment records, as well as a range of records relating to the running of the service including audits carried out by the manager and provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 9 March 2016

We inspected the service on 14 January 2016. The Grand is registered to provide accommodation, personal and nursing care for up to 82 people, some of whom are living with dementia. The service had opened in April 2015 and was not full; on the day of our inspection 44 people were using the service.

The service had a registered manager at the time of our inspection who had left the service in October 2015 and was in the process of deregistering. A new manager had been appointed and we had received an application from them to become registered. 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.

We found that risk assessments were in place for aspects of people’s care. Further information for staff on how to manage risks to people’s health were relocated into people’s care records following our inspection.

People were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The manager had shared information with the local authority when needed.

People received their medicines as prescribed and these were managed safely.

People were encouraged to make independent decisions and legislation to protect people who lacked capacity was being adhered to. Staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were protected from the risks of inadequate nutrition and specialist diets were provided if needed. Referrals were made to health care professionals for additional support or guidance if people’s health changed.

People were treated with dignity and respect and had their choices acted on. We saw staff were kind and caring when supporting people.

Improvements were required in relation to provider management systems to ensure they were effective in monitoring the service and responding to any issues. The manager and senior members of staff were carrying out audits at the service which had not identified that some information was absent from people’s care plans.

People were given opportunities to feedback their views on the running of the service and there was evidence that action had been taken in response to people’s views.