Granville

Granville is a residential care home providing respite accommodation and personal care for up to 14 people. Respite care allows those with caring duties to take a break, while the person you care for is looked after by someone else. The service provides support to people with a range of health conditions, including people with a learning disability or autistic spectrum disorder. At the time of our inspection there were 7 people using the service.

Granville is a spacious, extended and adapted building, with its own grounds and outside space. There are 14 bedrooms, some with specialist equipment such as tracking hoists and profile beds. Communal areas include wet rooms, toilets, large lounges, a dining area and a sensory room.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right support: People and their relatives told us they felt safe and supported. Risks were assessed and managed to ensure people could safely participate in activities that they enjoyed. People had their own bedrooms and appropriate equipment required during respite stays was provided. 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 were encouraged to do things for themselves, supported by a consistent team of staff who promoted their independence. People were able to receive visitors without restrictions in line with best practice guidance.

Right Care: People were supported to express their views and make decisions about their care. People were supported to maintain relationships, follow their interests, and take part in activities that were relevant to them. People had access to health care professionals when they needed them. People's privacy, dignity and independence were respected and promoted. People were safeguarded from abuse and avoidable harm. Staff understood their responsibilities to raise concerns and report incidents and were supported to do so. There were sufficient numbers of suitable staff and the provider operated safe recruitment processes.

Right Culture: There was a positive and open culture at the service and systems were in place to provide person-centred care. People and staff were involved in the running of the service and the provider worked in partnership with others to achieve good outcomes for people. Systems had been implemented to enable the provider to assess, monitor and improve the quality of the services provided and the provider was focused on developing these further. Any learning was identified and acted on. People benefitted from staying at a service that had an open and friendly culture. People enjoyed staying at the service and feedback we saw and received confirmed people enjoyed their respite stays.

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

Rating at last inspection

The last rating for the service was Good, published on 24 July 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

Follow up

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

We found the following examples of good practice.

Processes were in place to prevent visitors from catching and spreading infections. This included the provision of personal protective equipment (PPE), such as masks, gloves, aprons, face visors, hand washing facilities and hand gel. Temperature tests were done in a secure entrance area, and a Covid-19 questionnaire was completed. Lateral flow rapid Covid-19 testing was done.

There was adequate access and take up of testing for staff and people using services and very robust admission and discharge processes were in place for both young people and adults.

Shielding and social distancing rules were complied with. The layout of the premises promoted safety and reduced the potential for the transmission of infections. There was clear signage throughout the home on social distancing rules, and robust cleaning arrangements, including frequent deep cleaning, were in place. Staff wore a full range of PPE appropriately and consistently.

Staff training, practices and deployment showed the service could prevent transmission of infection and manage any outbreaks.

Granville is a respite service based in Eccles in the Borough of Salford, Manchester. Granville provides respite stays for up to three weeks for people 14 years of age upwards. The building is split into two accommodation settings. Accommodation to the ground floor caters for adults and consists of 12 bedrooms, as well as bathrooms, lounges, a kitchen and dining area. There are a further two bedrooms, bathroom and lounge area located on the first floor which caters for young people. There is a coded door between the two floors to keep both areas separate, however young people can spend time on the ground floor during the day should they wish to.

At the time of the inspection there was a registered manager who had been registered at the service since June 2015. 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.

We received positive feedback from people using the service, their families and staff members. Everybody we spoke with felt staff were supportive, friendly, respectful and understood people’s needs. Relatives were confident in the service and its ability to support their relatives safely and effectively whilst providing them with a period of recuperation.

Processes were in place to provide a suitable environment for all people using the respite service and its staff. Risk assessments were established to identify any risks associated with areas such as the use of hoists, bathing facilities, food hygiene and substances hazardous to health (COSHH).

A suitable amount of training and support was offered to ensure staff were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify external agencies where appropriate.

Staffing levels were sufficient to enable safe and personalised care and support to be provided to people using the service. Comments from people using the service, their relatives and staff supported this. Staff were expected to access training which ensured they had the correct skill base and experience to safely, knowledgeably and effectively support people using the service.

Recruitment procedures were in place to ensure appropriate steps had been taken to verify new employee's character and fitness to work. New employee induction processes ensured staff had the correct amount of support and training prior to commencing the role unsupervised. People and their relatives told us staff were knowledgeable about their individual support requirements. Staff demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.

The provider had appropriate processes in place for the safe administration of medicines; this was in line with best practice guidance from the National Institute for Health and Care Excellence. Senior staff were adequately trained in the administration of medicines and all medicines were stored securely and safely.

Each person had their own individual care file containing support plans, risk assessments and other relevant documentation. These records gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated well by means of liaising with families, regular support plan/ risk assessment review and information being recorded in the communication book which meant staff were kept up to date with any changes.

Staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provided legal safeguards for people who may be unable to make their own decisions. The management team also demonstrated their knowledge about what process they needed to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

All people we spoke with along with their relatives and staff, informed us the management structure was adequate and there was always a management presence throughout the service. This meant staff and people were able to seek appropriate advice and support when necessary. Each person informed us they were happy to approach management with any concerns or questions. People felt the registered manager and assistant managers were very supportive and would act on any issues they may have.

We found the ethos of the service was very much about providing a place where people could access respite, whilst feeling safe and being supported to develop the staff and management were very much a part of enabling this to happen.