Hunningley Grange Residential Home

Hunningley Grange is a residential care home providing personal care to up to 39 people. The service provides support to older people some of whom were living with dementia. At the time of our inspection there were 23 people living at the home.

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

Medicines were not always managed safely. Improvements were needed to ensure processes for recording people's medicines were robust and effective. A minimal number of activities were available to people. Further improvements were required in this area to ensure activities were available more often and were person-centred and meaningful to people. We have made a recommendation about the development of activity provision in the home.

Since the last inspection the provider had introduced dementia friendly signage to assist people in navigating around the home. Refurbishment and redecoration of the home was planned and ongoing.Checks were in place to ensure people lived in a safe environment.

Staff received training and support to carry out their role. There were enough staff available to meet people’s needs effectively. Risks to people had been assessed, monitored, and reviewed. People were supported to eat and drink sufficient to maintain a healthy diet.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were kind and caring. People and their relatives told us staff were approachable and friendly and offered support in a caring way. Care plans were informative and described people's needs and how they liked to be supported.

Although the service had significantly improved since the last inspection, further improvements were required. The provider had a system in place to monitor the quality of the service. However, this was not always effective in identifying areas of improvement. The registered manager gave assurance these improvements would continue to be further embedded, to ensure there was a continuous approach to improving care.

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 25 October 2022) and there were breaches of regulation. 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 the provider remained in breach of regulations.

This is the third consecutive inspection where the provider has been in breach of the regulations relating to safe care and treatment and good governance and has failed to achieve a rating of at least good.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to the proper and safe use of medicines and governance.

We have made one recommendation in the responsive key question. Please see this section for further details.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Hunningley Grange is a residential care home providing personal care to up to 39 people. The service provides support to older people and people were living with dementia. At the time of our inspection there were 27 people using the service.

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

We carried out a tour of the home and found concerns regarding infection prevention and control. Some areas required a deep clean. People received their medicines as prescribed. We informed the registered manager about some minor medication recording concerns and they took appropriate action to address these following our inspection. There were some occasions when there were not enough staff available to meet their needs effectively. Risks associated with people’s care needs had been identified and risk assessments were in place.

People were supported to have maximum choice and control of their lives and staff support people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The home was not always appropriately designed to meet the needs of people living with dementia. There were limited signage available to assist people to navigate around the home. People did not always have access to tactile objects and items of interest. People were supported to eat and drink sufficient to maintain a healthy diet. The menu was not displayed in a useable format. Staff received training and support to carry out their role. However, some training required refreshing in line with the provider’s policy. People had access to outside space, and we saw staff supporting people to use the garden area.

Staff were caring and assisted people in a kind way. People and their relatives told us staff were approachable and friendly and offered support in a caring way.

Care plans were informative and described people's needs and how they liked to be supported. However, there was a lack of activities and social stimulation available for people. There was very little available for people living with dementia to engage with. Staff used a screen to play bingo, but people could not see the screen or hear the numbers shouted out. Staff had to leave the activity several times to respond to call bell system.

The provider had a system in place to monitor the quality of the service. However, this was not always effective in identifying areas of improvement.

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 2 November 2020 and this is the first comprehensive inspection. We carried out a focused inspection, published 7 September 2021. This was to respond to concerns and looked at key questions of safe, effective and well-led only. The safe and well-led key questions were rated requires improvement with a breach in good governance.

The last rating for the service under the previous provider was good, published on 16 September 2020.

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.

We found evidence the provider needed to make improvements. You can see what action we have asked the provider to take at the end of this full report.

Follow up

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

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Hunningley Grange is a residential care home providing personal care to 23 people at the time of the inspection. The service can support up to 39 people.

The care home accommodates older people, some of whom live with dementia, in an adapted building with communal lounges and access to secure gardens.

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

Although environmental monitoring and checks took place, checks to lifting equipment had not taken place as required. Pre-employment recruitment checks took place, however the service was not able to find a staff file for one member of staff and therefore could not confirm checks had taken place. People were supported by a sufficient number of staff. Risks to people were assessed and regularly reviewed. However, staff had not always been vigilant in ensuring systems were in place to support people’s safety. Systems and processes were in place to safeguard people from abuse. Staff were confident managers would act on any concerns raised. Medicines were administered safely. Good infection and control prevention measures were in place, and staff adhered to PPE guidance. Accidents and incidents were monitored.

The governance framework had not identified the issues found during this inspection. There was no record of night spot checks. People clearly knew who the manager was and the manager knew people well. Staff said the home was well-managed. Continuous learning by the manager was evident. The service worked closely with health professionals.

Staff training was monitored, however not all staff on the training matrix had completed required training. The registered manager described plans to ensure this was completed. Staff told us they felt supported and supervisions took place. People were supported to eat and drink enough. Staff worked closely with external professionals to deliver effective support. People received good and regular access to health services. The environment was suitable for people's needs and some areas of the home had recently been refurbished. Consent to care was sought and recorded. People's needs and choices were assessed and care and support delivered within current guidance. 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 service was registered with us on 2 November 2020 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 16 September 2020.

Why we inspected

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

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.