We carried out a review of the data available to us about Kesteven Grange on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kesteven Grange, you can give feedback on this service.
Kesteven Grange is a purpose built home situated within a residential area in north Hull. It is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for 54 older people who may be living with dementia. Accommodation was provided over two floors and the first floor mainly housed people who were living with dementia. At the time of our inspection, the service was providing accommodation to 49 people used the service.
The service had 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 who used the service were protected from harm. The provider had safeguarding policies and procedures in place to keep people safe. Staff knew how to safeguard people from the risk of abuse and had received training.
Staff were recruited safely and we saw appropriate checks had been completed. The induction process for new members of staff was well established and thorough. Training was linked to the Care Certificate. The Care Certificate is a set of minimum national standards that health and social care workers should work to. The provider had put checks in place to assure themselves of the competency of staff and also reviewed staffing levels on a regular basis to ensure that the needs of people who used the service, were met. Staff received annual appraisals and regular supervision in accordance with the provider’s policies.
We saw the provider had systems and processes in place for the safe handling of medicines. We found minor recording issues, but were assured by the registered manager that these would be addressed immediately.
Staff supported the dietary needs of people who used the service. People were given a choice of foods, which catered to people’s preference and nutritional requirements. People who used the service told us there were always drinks and snacks available. Feedback on the menus was sought through meetings and questionnaires. Staff told us that the menu was regularly updated using this feedback.
We observed people were treated with dignity and respect. Staff behaved in a professional manner and told us they enjoyed their work. There were positive comments from people who used the service, their relatives and visiting health and social care professionals about the registered manager and staff team.
People who used the service 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. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and best interest meetings had taken place as required.
Personalised care was delivered through individualised care plans and risk assessments. Relatives of people who used the service told us they were involved in the care planning process. We found referrals to relevant community healthcare professionals had been made in a timely way.
People were supported to access activities in both the service and the local community. An activities co-ordinator provided a variety of activities such as arts and crafts and singing. Good links with the local community had been established and the provider had plans to expand these further in the next 12 months.
The records showed complaints were taken seriously and the outcome was followed up. People told us they knew how to complain and were sure their complaints would be addressed.
There was a quality monitoring system in place, which consisted of audits, checks, and obtaining people’s views. Surveys and meetings were carried out and the results used to drive improvement. The registered manager held a monthly surgery so that people could express their views and opinions. We saw that minutes of these meetings had been taken and feedback given.
The provider recognised the work of staff through recognition award schemes. People who used the service and their relatives were involved in this by being able to nominate members of staff for awards.
Further information is in the detailed findings below.
Kesteven Grange is a purpose build service situated within a residential area in North Hull. It is registered with the Care Quality Commission [CQC] to provide accommodation and personal care for 54 older people who may have dementia.
This inspection took place on 11 and 12 August 2015 and was unannounced. The service was last inspected in August 2013 and was found to be compliant with the regulations inspected at that time.
There was a registered manager in post. A registered manager is a person who has registered with the CQC 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.
Staff understood they had a responsibility to protect people who used the service from harm and knew how to report any abuse they may witness or become aware of. They had received training in this subject and this was updated regularly. Staff were provided in enough numbers to ensure the needs of the people who used the service were met and they had been recruited safely. This ensured, as far as practicable, people who used the service were well cared for, their needs were met and they were not exposed to staff who had been barred from working with vulnerable people. The service was clean and there were no malodours. People’s medicines were administered as prescribed by their GP and staff had received training in this subject. Systems were in place to ensure people’s medicines were administered safely.
People were provided with a wholesome and varied diet which was of their choosing. Staff monitored people’s dietary needs and involved health care professionals when required. Staff received training which was relevant to their role and equipped them to meet the needs of the people who used the service. Staff received support from the registered manager to gain further qualifications and experience. People were supported to make informed decisions and legislation was used to protect people’s rights and choices where needed. People who used the service were supported to lead a healthy lifestyle and supported to access health care professionals when required, for example GPs and district nurses.
People had good relationships with staff who were kind and caring. Staff understood people’s needs and how these should be met. People who used the service or their representatives were involved with the formulation of care plans. These described people’s preferences for the care they required and how this should be delivered by the staff.
People who used the service could choose from a range of daily activities to participate in. Trips out into the community were also available. Staff had access to documentation which described the person and their preferences. People who used the service and their relatives knew they could raise concerns or complaints if they wished. These were investigated and the outcome shared with the complainant.
People lived in well led and inclusive service and the registered manager sought their views about how it was run. The registered manager undertook audits which ensured people lived in safe environment and their health and welfare was monitored and upheld. Staff were supported and encouraged to achieve excellence and systems were in place which identified short falls in the service and how these should be improved.
Information was available for staff to follow to ensure people who used the service were cared for safely. People told us they found the staff approachable and caring. One person said, 'They just cannot do enough for you, they bend over backwards to make sure we're cared for.'
The environment was clean, tidy and well maintained. There were enough toilets and bathrooms for people to use; these were fitted aids and adaptations to enable people to use these facilities safely.
The recruitment procedures in place made sure staff were recruited safely and people were not exposed to anyone who had been barred from working with vulnerable adults.
We found the services offered by the home were monitored and audited and people could have a say about how the home was run. One person told us, 'We fill out questionnaires and have regular meetings.'
The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service and a practising professional.
During lunch we completed a detailed observation called a 'short observation for inspection' (SOFI). This enabled us to observe people who were unable to tell us about their care due to their dementia care needs. We completed the SOFI for 36 minutes and recorded observations of four people at three minute intervals. This enabled us to record signs of wellbeing and the interactions people had with their surroundings, staff and other people who lived in the home.
People told us they were able to make choices and that staff treated them with respect. They confirmed staff listened to them and acted on their wishes. They said they were encouraged to participate in a range of activities, but if they preferred not to this was accepted and their choices respected. All the people spoken with were happy with the care they received. Comments were, 'I really can't fault it', 'It's a wonderful place' and 'There are plenty of choices ' we can have a bath whenever we want.'
People told us they liked the meals on offer in the home and they had choices available to them. They said they received plenty to eat and drink. They said the food was served hot. One person told us the portion sizes could be better for their smaller appetite. People confirmed they were able to eat their meals where they choose.
People spoken with told us they were well cared for in the home. People said they would speak to their key worker or the manager if they had concerns. Comments included, 'The manager comes round at least twice a day to check everyone is ok', 'There is always someone ready to listen' and 'I do feel safe in here.'
People said that call bells were answered quickly and they were never kept waiting long when they needed assistance. They said they were happy with the care they received from staff. We spoke with two relatives during the day and they told us there was always staff around to talk to. One told us they visited the home every day for years and said, 'They speak nicely to people, I have never heard the staff speak in a nasty way.'
Some people spoken with were not aware of their care plan but said they did not want to be involved in it. They said they were just happy for staff to check they were all right during any care provided.