Archived: Rastrick Grange

Rastrick Grange is a purpose built home. It offers residential care for 39 people living with dementia. The accommodation is arranged over three floors. All of the bedrooms are single and have en-suite toilets and showers. There are lounges and dining rooms on each floor. There is a garden area at the side of the building that can be used in fine weather and a car park to the front of the building.

At the time of this inspection there were 37 people using the service.

There was a registered manager in place. 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.

There were not always enough staff on duty to care for people safely or to make sure their needs were met in a timely way. People told us they liked the staff and found them kind and caring. We witnessed some warm and good humoured relationships between people using the service and staff.

People told us they felt safe in the home. Staff had a good understanding of how to control risks to people’s health, safety and welfare.

Staff told us they felt the quality and variety of meals could be improved. We found people’s choice of meal was very limited, as people living with dementia were being expected to choose their meals a day in advance rather than being able to see the meals to make an informed choice. The mealtime experience for people varied depending on which floor or which staff were assisting them.

We found people had access to healthcare services and these were accessed in a timely way to make sure people’s healthcare needs were met. Safe systems were in place to manage medicines; however, people did not always receive their medicines at the correct times.

We found the service was meeting the legal requirements relating to the Deprivation of Liberty Safeguards (DoLS).

Visitors told us they were made to feel welcome and if they had any concerns they would speak to the registered manager or another member of staff.

We found some of the audits which were in place were effective. However, there was a lack of environmental audits or use of a tool to calculate staffing levels. This meant the service was not monitoring its quality in these areas and responding where improvements were needed. Relatives told us they did not always feel their views were being listened to.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and you can see what action we told the provider to take at the back of the full version of the report.

We looked at the care records of four people and saw that three of the records contained consent documents which had been signed by the person's relative. We were unable to find the reason for this documented within the care record. We were also unable to find evidence of the home carrying out assessments of people's mental capacity. This was in relation to people making decisions about the care they received at the home. There was no evidence of any learning from incidents and incidents were not investigated. This meant appropriate changes that would reduce the risk of incidents recurring were not being made.

We said that improvements were needed.

We returned on this inspection to check whether improvements had been made.

We looked at the care records of three people and found there were now documents in place for the purpose of obtaining consent from people. We also found that, where people were not able to give consent the home were completing assessments of people's mental capacity.

We saw that numbers of care staff on duty had increased by 84 hours per week, and a staff member had been employed for the purposes of arranging and providing activities.

We spoke with the manager who told us that learning from incidents was now taking place.