Background to this inspection
Updated
16 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was completed by two inspectors.
Capwell Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We spoke with the local authority to gain their feedback about the service. We reviewed the information the provider sent us each month following the last inspection. We also reviewed other information about events the registered manager must notify us about. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with six people who lived at the home. Most people were unable to communicate with us so we completed many observations. We also spoke with the deputy manager, registered manager, the managers of three bungalows, three members of staff and the area director.
We reviewed records for eight people, in relation to pressure care management, percutaneous endoscopic gastrostomy (PEG) care. We reviewed people’s food, fluid, and weight management. Medication charts, and care plans were also reviewed. We also reviewed two member of staff’s recruitment checks.
After the inspection
We continued to seek clarification from the deputy and registered manager about the evidence found. We looked at mental capacity assessments, training records, audits, and safety checks. We spoke with six people’s relatives and a person who had lived at the home. We also spoke with a further nine members of staff.
Updated
16 June 2021
About the service
Capwell Grange is a nursing and residential care home. Providing personal and nursing care to 83 people, most of whom were living with dementia and long-term physical conditions, at the time of the inspection. The service can support up to 146 people. The home is made up of five individual bungalows with each having its own manager. One of the bungalows is a rehab service supporting people to regain their independence following a period of ill health.
People’s experience of using this service and what we found
One person’s relative said, “ It has improved by 90 per cent, we were thinking of moving [family member]. But proof is in the pudding, we shall have to see.” One person told us, “I was wheeled into Capwell Grange, but I walked out. They [staff] gave me back my independence, it changed my mind what a nursing home was like.”
We found improvements had been made to the home in terms of promoting people’s safety and effectively responding to people’s nursing and health needs. People were protected against potential harm and abuse. Swift action was taken to respond to injuries and changes in people’s health needs.
However, we did identify some shortfalls in responding to potential neglect, when people first moved into the home from a hospital or another residential care home. We made a recommendation about the management of potential safeguarding concerns at the home.
Improvements had been made in the leadership of the home. The bungalows were well managed by managers who knew people's needs well. Staff were directed and supported to care for people. The deputy and registered manager monitored the quality of daily care.
The provider’s own monitoring of the service had also improved; however we did find some shortfalls in this area. We made a recommendation about the provider improving their systems to assess the service. This will help the provider to sustain the changes made.
Staff were recruited safely and given the support and training to perform well in their work. Staff received competency checks to see if they could meet people’s needs effectively or if they needed further training.
People received their medicines as prescribed. The home was clean, and the registered and deputy manager ensured staff followed up to date COVID-19 government guidance. Relatives were supported to visit their family members in a safe way.
Those with specialist diets were supported to eat and drink in a safe way. Professional input was sourced quickly when people showed signs of choking and losing weight.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The environment had improved. Efforts had been made to make the bungalows look inviting and comfortable for those who lived there. This work was continuing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update. The last rating for this service was inadequate (published 24 October 2020) there were multiple breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 30 September 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.