Archived: Gracewell of Adderbury

Gracewell of Adderbury is a care home providing accommodation for up to 60 older people, including people living with dementia. At the time of the inspection there were 53 people living at the home.

People’s experience of using this service and what we found

We received information raising concerns about staffing levels, increased number of falls and poor management of the home. We wrote to the provider and asked for information around their systems and processes. This included policies, staffing rota’s, falls risk assessments and quality assurance systems.

We inspected the home, which included visiting the home and speaking with people. We also spoke with staff and relatives virtually. We found the service had enough staff to meet people’s needs. People told us they did not have to wait to be attended to. During the inspection, call bells were answered in a timely manner and staff did not look rushed. Relatives told us they had never had any reason to think there were not enough staff to care for people. Staff told us they were enough staff to meet people’s needs.

We found risks in relation to falls had been identified and there were management plans in place. Equipment was used to prevent falls including beam sensor mats. A lot of work had been completed to ensure falls were managed and reduced throughout the home. This had included staff training around falls management.

We found people were protected from the risk of acquiring infections and the service was clean. Personal protective equipment was readily available to staff and all staff were following the latest guidance.

Prior to the inspection we received anonymous concerns that the service was poorly managed. There was a registered manager who had been in post for 6 months and had made significant positive improvements. People and relatives told us the home was well managed. Staff told us the manager was very supportive and included them in decisions about the changes. The provider had effective quality assurance systems in place which were used to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Published 24 May 2018)

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about staffing levels, increased falls and poor management of the service. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gracewell of Adderbury on our website at www.cqc.org.uk.

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.

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. They are: Gracewell Healthcare Limited and Gracewell Healthcare 3 Limited. This means the service is subject to one inspection visit however the report is published on our website twice, under each provider.

At this inspection we found the service was Good in all five domains and Good overall.

We were warmly welcomed by the staff that were forthcoming in speaking to us and there was a pleasant and calm atmosphere throughout the day. Gracewell of Adderbury had a clear staffing structure in place and staff knew their roles and responsibilities.

The service’s deputy manager was acting up as a general manager and there was a recruitment process in place for a new 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, relatives and staff were all complimentary about the service and how it was managed. The staff at Gracewell of Adderbury received good support from the providers’ senior management team. There were quality assurance and monitoring systems in place that effectively identified areas for improvement. The management ensured where required appropriate action was promptly undertaken.

People were safe and told us they had no concerns. Staff knew how to report safeguarding concerns and they knew how to report to external agencies if needed. People’s care files contained detailed risk assessments that included management plans to keep people safe. There was a system to manage accidents and incidents. The management ensured lessons were learnt where possible and a preventative action taken as necessary.

People were supported by sufficient number of suitable staff and providers ensured safe recruitment processes were followed. People were cared for by staff that received ongoing training and support to carry out their roles effectively.

People’s rights to make their own decisions were respected. The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. 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 were supported to access health services. The team worked well in partnership with health and other professionals where required. People were positive about the food. They were supported to meet their nutritional needs if required and there were systems in place that ensued people’s weights and well-being were maintained.

The service was caring and people complimented the compassionate nature of staff. The providers ensured staff worked to organisational values such as kindness, empathy, integrity and respect. People were supported to maintain their independence and they were involved in their support. People’s dignity, privacy and confidentiality were respected.

People’s needs were assessed prior to admission to the service to ensure their needs could be met. This included people’s physical needs as well as emotional needs. People told us they received support that met their needs and that staff knew them well. People were provided with a variety of activities, according to their needs and choices. People and their relatives knew how to make a complaint and told us they had no hesitation in raising concerns as these were addressed promptly.