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We are carrying out a review of quality at Foxburrow Grange. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Good

Updated 22 March 2018

The inspection was unannounced and took place on 7 and 15 December 2017. Foxburrow Grange is registered to provide accommodation and nursing care for up to 66 older people. The service is split into four units, each of which has separate adapted facilities. On the day of the inspection there were 59 people living at the service.

At our last inspection on 10 March 2017, we found the provider to be in breach of multiple regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found incomplete risk assessments and a lack of clear guidance for staff about how to manage risks and mitigate the potential of reoccurrence. Staff did not always understand their responsibilities to ensure people were given choices about how they lived their lives and consent to care was not always sought in line with current legislation. People’s food and fluid intake was not always accurately monitored to ensure that they were protected from the risk of dehydration. Staff had not completed essential training or received annual appraisals and did not have access to regular supervision to support their professional development. The provider and failed to maintain a clear oversight of the service. We gave the home an overall rating of requires improvement and rated the area of effective as inadequate. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of the service.

At this inspection, we looked to see whether the provider had implemented the action plan. We found the provider had made the required improvements to improve the standard of care and they were no longer in breach of any regulations. Since the last inspection, the provider had appointed a new registered 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.

Following the previous inspection improvements had been made to people’s risk assessments. They now reflected people’s needs and contained clear guidelines for staff to protect people from harm. Staff received training on how to recognise signs of abuse and were clear about what action to take if any concerns arose.

Staff sought consent before providing care and consistently worked in line with the legislation of the Mental Capacity Act 2005 and no unnecessarily restrictive practices were in place. Since the previous inspection, the service had commissioned a new training provider to deliver training to staff on how to support people with dementia who may be resistive to personal care; In addition, one-page profiles highlighting key risks and how best to support people were in each person’s daily files.

Staff had completed a variety of training sessions. This meant people received care from skilled staff who were able to meet their needs. Staff received supervision and annual appraisals to support them in their role and identify any learning needs and opportunities for professional development.

Staff had completed nutritional assessments. Where people were found to be at risk of malnutrition or a low fluid intake this was clearly recorded in their care plans, and staff effectively monitored and recorded their food and fluid intake. Where staff had identified concerns about people’s nutritional status specialist advice was sought from healthcare professionals such as the dietician and speech and language therapist.

The service had a robust recruitment process in place to ensure that staff had the necessary skills and attributes to support people using the service. New members of staff completed an induction programme during which they completed training sessions and were introduced to, and spent time with, the people that

Inspection areas

Safe

Good

Updated 22 March 2018

The service was safe.

Staff knew how to protect people from harm and were confident in the action they would take if any concerns arose.

Risk assessments were individualised and reflected people�s current needs.

There were enough staff available to support people safely and meet their needs.

Staff managed medicines safely.

Effective

Good

Updated 22 March 2018

The service was effective.

Staff sought consent before providing care and consistently worked in line with the legislation of the Mental Capacity Act 2005.

Staff had completed training, which provided them with the skills and knowledge to fulfil their roles.

Staff received supervision and annual appraisals to support them in their role and identify any learning needs and opportunities for professional development.

Staff had completed nutritional assessments. Where staff found people to be at risk of malnutrition or a low fluid intake an effective system was in place for staff to monitor their food and fluid intake.

Caring

Good

Updated 22 March 2018

The service was caring.

Relatives were involved in planning their family member's care.

Staff treated people with dignity and promoted independence wherever possible.

Responsive

Good

Updated 22 March 2018

The service was responsive.

Improvements had been made to the process for assessing people before they moved into the service. This ensured staff were able to meet their needs.

People received person-centred care, which empowered them and enriched their lives.

People were confident that the registered manager would respond promptly and effectively to verbal and written complaints.

Well-led

Good

Updated 22 March 2018

The service was well-led.

The provider had worked in conjunction with an external source and the local authority to embed changes within the service and address the shortfalls found during the previous inspection.

The provider actively sought, encouraged and supported relative�s involvement in the development and improvement of the service.

Quality assurance processes were in place, which provided the registered manager with a clear oversight of the service.