Grangefield Residential Care Home

Grangefield Residential Care Home is a residential care home providing accommodation and personal care for up to 23 people. The service provides support to people over 65 and specialist support to people living with dementia. At the time of our inspection there were 17 people using the service.

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

Records were not always person centred and language used was not always respectful. Not all required notifications had been made to CQC as required by law. The provider had robust systems in place to monitor quality within the service. The provider and registered manager acted promptly to make changes following the areas highlighted during the inspection. Relatives told us communication was excellent.

People were protected from the risk of harm and felt safe. Staff were aware of how to raise any safeguarding concerns. Risk assessments provided guidance to ensure staff could provide safe care. Medicines were managed safely. The provider was working within current government guidance in relation to infection control and there were no restrictions upon visiting arrangements. Incidents and accidents were acted upon appropriately and lessons were learned when things went wrong. People described feeling safe and well cared for.

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.

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 requires improvement (published 25 February 2021). At our last inspection we recommended the provider reviews all risk assessments and strategies in place to ensure staff are following them. At this inspection we found the provider had taken action; risk assessments were regularly reviewed, and staff were following them.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Grangefield Residential care home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice

Safe arrangements were in place for professionals visiting the service. This included a confirmed negative lateral flow test, vaccination against COVID-19, COVID pass, hand sanitisation and wearing personal protective equipment (PPE). There were plentiful supplies of personal protective equipment (PPE) throughout the designated setting which included gloves, masks and aprons for people if required.

There were PPE stations located around the setting and outside bedrooms where people are required to isolate.

Isolation, cohorting and zoning will be used to manage any potential spread of infection. This meant people will be admitted in the knowledge they are required to isolate in their bedroom until they have completed their period of isolation.

Staff participate in a daily and weekly testing regime prior to commence work. All staff had a designated area to change their clothes before and on completion of their shift.

We saw various cleaning and disinfection records which included regular high touch point cleaning to ensure the potential for cross infection had been reduced.

Policies, procedures and risk assessments related to COVID-19 were up to date which supported staff to keep people safe.

All staff had completed training in relation to infection control, and recently received training about the correct use of PPE including donning and doffing. There are further training refreshers planned to ensure staff knowledge is kept up to date. Spot checks will be used to ensure staff adhere to the training provided

Grangefield Residential Care Home is a residential care home providing personal care to 13 people aged 65 and over at the time of the inspection. The service can support up to 23 people.

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

Monitoring and management of people’s identified risks required improvement. Unexplained bruising on people had not been investigated for possible cause and body maps had not been used to accurately record any bruising. We have made a recommendation about risk assessments and monitoring

Safety checks were in place for the environment however, there was no record of water temperate checks for baths and showers prior to people using them. Audits had not identified gaps in recording of care delivery such as fluid charts, bowel movement charts and oral hygiene.

Medication administration records (MAR) were in place and people’s medicines had been administered as prescribed. However, Protocols were not consistently in place.

Audits had not identified gaps in recording of care delivery such as fluid charts, bowel movement charts and oral hygiene.

We were assured that infection prevention and control measures were in place and being followed by staff.

People and their relatives were positive about the care and support provided. Staff were recruited safely and there was enough staff to meet people’s needs.

We were assured with infection control.

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 10 April 2020).

Why we inspected

We received concerns in relation to infection prevention and control at the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what action was necessary and proportionate to keep people safe as a result of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Grangefield Residential Care Home 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.

Grangefield Residential Care Home is a residential care home for up to 23 older people. At the time of inspection there were 18 people living at the home.

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

Improvements were required in the assessment and monitoring of the environment. The provider responded to feedback and made immediate changes to improve the safety of the home.

The management team continually monitored the quality of the service, identifying issues and making changes to improve the care. There was an open culture which promoted clear communication between staff and management which had enabled the provider to make improvements to all areas of the service.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. People were supported to access relevant health and social care professionals.

There were enough staff deployed to meet people’s needs. People’s medicines were managed in a safe way. People’s risks were assessed at regular intervals or as their needs changed. Care plans informed staff how to provide care which mitigated these known risks.

People received care from staff they knew. Staff had a good understanding of people's needs, choices and preferences. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. Staff gained people's consent before providing personal care.

People were involved in the planning of their care which was person centred and updated regularly. People were supported to express themselves, their views were acknowledged and acted upon. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

Staff were recruited using safe recruitment practices. Staff received training to enable them to meet people’s needs and were supported to carry out their roles.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 21 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

What happens next?

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.

At the last inspection in July 2015, the service was rated Good; at this inspection we found the service remained Good.

There was a registered manager who registered with CQC in February 2016. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service continued to provide safe care. Staff understood their responsibilities for safeguarding people from harm and followed the provider’s policies to provide people’s prescribed medicines safely. There were enough suitably skilled staff to meet people’s needs. Staff had been recruited using safe recruitment practices.

People received care from staff that had received training to meet people’s specific needs and had supervision to assist them to carry out their roles.

People received care from staff they knew, which helped to forge positive relationships. People were supported emotionally and practically to maintain their independence and well-being.

People received a balanced diet from staff that understood their dietary needs. People were supported to pursue their hobbies and interests and continue to celebrate special days.

People were treated with respect and helped to maintain their dignity.

People were supported to access healthcare professionals and staff were prompt in referring people to health services when required.

People’s risks were assessed and staff had followed plans that were centred on the person as an individual Care plans were updated regularly and people and their relatives were involved in their care planning where possible.

Staff sought people’s consent before providing care and people’s mental capacity was assessed in line with the Mental Capacity Act 2005. The registered manager understood their responsibilities and referred people appropriately for assessment under the Deprivation of Liberty Safeguarding.

The provider and registered manager continually assessed, monitored and evaluated the quality of the service; they identified areas for improvement, and implement change where required.

We looked at the medicine administration records for eight people and how the service stored and managed medicines. We found that arrangements were in place to ensure that medicines were managed safely.