Deewater Grange

Deewater Grange is a care home providing accommodation, personal and nursing care for up to 58 older people in one adapted building. The service supports younger and older adults living with physical disabilities and dementia. The service has separate wings supporting residential dementia care, nursing dementia care and general nursing. All of people’s rooms have en-suite facilities. Communal bathing and toilet facilities are also located throughout the care home. At the time of our inspection, there were 51 people using the service.

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

Recruitment procedures were robust and demonstrated staff were safely recruited. Staff completed an induction and undertook shadow shifts to support their understanding of the role and the people they supported.

People were protected from the risk of abuse. Safeguarding policies and procedures were in place. Staff had received training and understood how to keep people safe. They knew who to report to if they had any concerns.

People’s needs had been assessed prior to living at the service. Individual risk assessments were in place to highlight areas of risk and give clear guidance to staff about how to minimise any risks identified. People living with dementia that may use behaviour to express a feeling had clear support plans and risk assessments in place where needed.

The management and administration of medicines was robust with clear procedures in place. The management of people's 'as required' medicines was safe with clear and consistent records were in place. Medicines were managed by trained and competent staff.

The staff and management team had developed positive relationships with people and their relatives. They had an excellent understanding of how to meet people’s individual needs and fully understood their routines and preferences.

Safety checks of the premises and equipment had been undertaken. All areas of the service were clean and well maintained. People had personal emergency evacuation plans (PEEPs) in place.

There were effective systems in place to monitor the quality of the care provided. The management team identified and promptly addressed any areas identified for development and improvement.

The staff and management team worked closely with health and social care professionals to ensure the best outcomes for people.

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.

Rating at last inspection

The last rating for this service was good [Published 10 September 2022].

Why we inspected

We received concerns in relation to staff skills, the management of behaviours that may challenge and the providers assessment process. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern.

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

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.

Follow up

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

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

Staff followed national guidance in relation to COVID-19, infection prevention and control and wore PPE appropriately. The service was clean and hygienic. The recruitment of staff was safe and there were enough staff on duty to meet people’s needs. People received their medicines when they needed them from trained staff. Risks to people’s health and safety had been assessed and mitigated and equipment had been serviced and maintained.

Accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence. Local safeguarding protocols were followed, and stakeholders had been informed when incidents had occurred. People and their relatives felt the service was safe.

People had benefited from the purpose-built environment providing wide hallways and a range of homely lounges to spend their time in. Staff had completed training that the provider considered essential to their role and had the opportunity to discuss their training and development needs with their manager. People's relatives spoke highly of the staff team who they described as kind and caring. They told us they were kept informed of their loved one’s wellbeing and felt their loved ones were well care for.

People were supported to eat a balanced diet that met their assessed dietary needs. 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.

People’s care and support was planned and kept under review to make sure the support they received continued to meet their personal needs and preferences. People had the opportunity to take part in a range of activities that were meaningful to them. People were offered the opportunity to give their views of the care they received and knew how to make a complaint.

A quality assurance system was in place, with regular audits being completed and actions taken to address any shortfalls identified. Staff felt well supported by the management team, who they felt were approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 January 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service was registered.

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.

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.

We found the following examples of good practice.

¿ All visitors were asked to complete a health screening form and have their temperature checked before entering the service. Personal protective equipment (PPE) was available for visitors along with access to handwashing facilities and hand sanitiser.

¿ People and staff were taking part in regular COVID-19 testing.

¿ People had individual care plans in place that reflected their visiting arrangements and how they kept in touch with loved ones.

¿ Staff had all received training in infection prevention and control, COVID-19, handwashing and the wearing of PPE.

¿ The service had increased the cleaning schedules and routines to reduce the risks of cross infection.

¿ Staff had access to PPE and wore it appropriately.

¿ Staff had been kept informed of how to work safely throughout the pandemic and were confident in supporting people with a COVID-19 positive diagnosis.

¿ Clear processes were in place for the management of people with a COVID-19 positive diagnosis. The provider was following national guidelines.

Further information is in the detailed findings below.