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Inspection carried out on 7 August 2018

During a routine inspection

Grassington House is a residential care home for 13 older people living with dementia, mobility difficulties and sensory impairment. There are three floors with the first floor having access via stairs or a lift, access to the third floor is by stairs or stair lift. There is a smaller dining room, a television lounge and a large conservatory lounge leading out onto the gardens. There is level access to the gardens and various seating areas. There were 12 people living at the home at time of inspection.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and the who to report this to if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults.

When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

The service was responsive when things went wrong, were open and reviewed practices and produced action plans to aid learning.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with routine audits to ensure safety with medicines.

People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with professionals such as doctors, occupational therapists and social workers.

People had their eating and drinking needs understood and were being met. People were happy with the quality, variety and quantity of the food. People living in the home were involved in menu planning, shopping for food and their nutritional needs and preferences had been assessed.

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. A person told us “I just let the staff know I am going out and I go out whenever I want”.

The registered manager actively sought to work in partnership with other organisations to improve and nurture positive outcomes for people using the service.

Care and support was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. Staff felt supported and confident in their work.

People, their relatives and professionals described the staff as caring, kind, affectionate and warm. People were able to express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected. A relative said “The reason we chose Grassington House is because it felt like a family, not a just a home”.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories were detailed and people important to them had been consulted.

The home had an effective complaints process and people were aware of it and knew how to make a complaint. People and their relatives felt they would be listened to and actions taken if they raised concerns. The service actively encouraged feedback from people.

People’s end of life needs were assessed and very detailed these included their individual spiritual and cultural wishes. The records showed that people and their relatives had been involved in these plans.

Group and individual activities were provided. People were consulted about what they liked to do with their day. Many people went out throughout the day and some liked to be involved with task around the home. A person told us, “I help around the home, it makes me feel very much better”.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone. A relative told us “They are open with thei