Background to this inspection
Updated
29 November 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was undertaken by two inspectors and an Expert 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
Grange Cottage is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Grange Cottage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there were two registered managers in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service, their action plan following the last inspection and information received from the local authority. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people, 2 relatives and 9 staff. Including care workers, senior care workers, the registered managers, the deputy manager, the activities coordinator, the cook and domestic staff. We undertook general observations and observed how people spent their time and interactions between them and staff. We reviewed 5 people’s care records, 3 staff records and records relating to the management of the service.
Updated
29 November 2022
About the service
Grange Cottage is a residential care home providing personal care to up to 33 people. The service provides support to older people, many of whom are living with dementia. The home does not provide nursing care. At the time of our inspection there were 30 people using the service.
People’s experience of using this service and what we found
People received safe care. There were sufficient numbers of staff to provide people with the level of care they needed. Staff were knowledgeable of the risks to people’s safety and supported people to minimise those risks. Care records provided detailed information about risk management. There were processes in place to safeguard vulnerable adults and learn lessons from any incidents that occurred. People were protected from the risk catching and spreading viruses and staff’s practice was in line with current government guidance regarding the covid-19 virus. People received their medicines as prescribed.
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. Staff obtained people’s consent prior to providing support or liaised with those authorised to make decisions on people’s behalf when people did not have the capacity to consent to care. Staff liaised with healthcare professionals to ensure people’s health needs were met. Staff provided people with any support they required at mealtimes to ensure their nutritional needs were met. Staff received regular training to ensure they had the knowledge and skills to undertake their duties.
Staff had built good working relationships with people and had taken the time to get to know the person, including their life histories, their interests and hobbies. People, and their relatives, were involved in their care. People’s privacy and dignity was maintained, and people were supported to maintain their independence.
Care records had been improved to ensure staff had up to date accurate information about people’s needs and enabled them to provide person-centred care. Staff were aware of people’s communication needs and used a combination of verbal and non-verbal communication to ensure they understood what people were communicating. A full activities programme was in place to ensure people were stimulated and there had been an increase in opportunities to visit local amenities in the community. A complaints process was in place to ensure any concerns raised were appropriately investigated.
There were governance systems in place to review the quality and safety of the service. Unfortunately, at the time of our inspection these systems had missed some minor improvements required. As soon as we bought these improvements to the registered managers attention, prompt action was taken to address the concerns, including improving the storage of topical creams, restricting one window and updating infection prevention and control risk assessments to be in line with current practice. There were systems in place to obtain the views of people, their relatives and staff about the service and incorporate their ideas to ensure continuous improvement.
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 3 February 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.