Background to this inspection
Updated
18 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team comprised of two inspectors, one inspection manager, one pharmacist and two experts by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Wood Hill Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. This means the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also sought feedback from partner agencies who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 16 people who used the service about their experience of the care provided and 12 relatives. We spoke with staff, including on duty care staff, nurses, domestic and kitchen staff. We also spoke with the manager and the senior management team. We spent time observing daily life at the home.
We reviewed a range of records, including medication administration records (MAR’s), care records staff personnel files, training records as well as information relating to the health and safety and management and oversight of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
18 January 2020
About the service
Wood Hill Grange is a nursing and residential home, which at the time of this inspection was providing personal and nursing care to 53 adults and older adults, some of whom were living with dementia. The home comprises of four floors. The service can support up to 75 people.
People’s experience of using this service and what we found
The service had significantly improved and feedback from the previous inspection had been addressed before we came to inspect. The service had a new manager in place. They had worked for the provider for over nine years and we saw they had a positive working relationship with their staff team. One staff member said, “The manager is great, best manager we have had.”
The management team conducted audits and checks to further ensure the quality and safety of services provided to people. The operation of the quality assurance processes had significantly improved and actions arising from audits were being recorded and progressed. Most minor improvements identified during the inspection visit, the senior management team were already aware of and actively working to address.
People felt safe whilst being supported by staff who had the relevant knowledge and confidence to identify safeguarding concerns and act on these to keep people safe. Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. Risks to people's personal safety were assessed and measures put in place to minimise those risks. During the inspection we identified minor improvements to how medicines were managed and immediately after the inspection the provider sent us a list of actions they had taken to address these concerns. We were assured people’s medicines were managed safely.
The service used a number of creative methods to ensure people and relevant persons involved in their care had a voice, which was valued and listened to.
Staff were respectful, considerate and incredibly positive towards people and their relatives. It was paramount to the service to ensure people's wellbeing was respected and protected. People and relatives confirmed staff always respected their privacy and maintained their dignity. People benefitted from living at a service that had a very open and welcoming culture. One relative said, “They’re [staff] like my second family to me, I have a meal here, I have lunch, whatever they’re serving I have it”.
People received support that was individualised to their specific needs. Their needs and support plans were kept under review and promptly amended as changes occurred. Staff knew people and their needs well, and we saw caring interventions and conversations throughout our inspection. A range of meaningful activities were on offer to keep people occupied, according to their individual interests. 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 interest. 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 (and update)
The last rating for this service was requires improvement (published 19 November 2018) and there were two breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.