Archived: Gracewell of Chingford

Updated 1 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted by an increase in incidents being reported. This inspection took place on 17, 21 and 24 December 2018 and was unannounced. One inspector and an expert-by-experience visited the service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience had personal experience of caring for an older person with dementia.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Before the inspection, we looked at the evidence we already held about the service including notifications the provider had sent to us. A notification is information about important events which the service is required to send us by law. We also contacted the local authority with responsibility for commissioning care from the service to seek their view about the service.

During the inspection, we spoke with eleven staff which included the director of operations, registered manager, deputy manager, administrator, activity co-ordinator, maintenance person, the chef, two senior care assistants and two care assistants. We also spoke with six people who used the service and seven relatives. We observed care and support provided in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us. We reviewed six people’s care records including risk assessments and care plans and reviewed four staff records including recruitment and supervision. We looked at records relating to how the service was managed including staff training, medicines, policies and procedures and quality assurance documentation.

Updated 1 February 2019

Gracewell of Chingford is a care home for 46 older people, some of whom may be living with dementia. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is spread out over three floors. At the time of this inspection there were 45 people using the service.

This care home is run by two companies: Gracewell Healthcare Limited and Bayfield Court Operations Limited. These two companies have dual registration and are jointly responsible for the services at the home.

This inspection took place on 17, 21 and 24 December 2018. The inspection was unannounced. At the last inspection in October 2016, the service was rated as Good. This inspection was prompted by an increase in incidents being reported. At this inspection we found the service had met all relevant fundamental standards and remained Good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff were knowledgeable about reporting abuse and whistleblowing. There were enough staff on duty to meet people’s needs. The provider had safe recruitment procedures in place. Risk assessments were carried out to mitigate the risks of harm people may face. Building and equipment safety checks were carried out. Medicines were managed safely. People were protected from the risks associated with the spread of infection. Accidents and incidents were recorded, and lessons learnt from these.

People had their care needs assessed before they began to use the service. Staff were supported to carry out their role effectively through supervisions, appraisals and training. People were offered choices of nutritious food and drink and staff were knowledgeable about people's dietary requirements. Staff assisted people to maintain their health. The provider had systems in place for the staff team to share information about people’s well-being. The building was tastefully decorated. However, the décor of the building meant some people could have difficulty finding their bedroom. The provider was in the process of refurbishing the building. Care was provided in line with the requirements of the Mental Capacity Act (2005). Staff understood the need to obtain consent before delivering care.

People and relatives thought staff were kind and caring. Staff explained how they got to know people and their care needs. People and their relatives were involved in decisions about the care. Each person had a named care worker who had overall responsibility for their care. Staff knew how to provide an equitable service. People’s privacy, dignity and independence were promoted.

Staff understood how to provide a personalised care service. Care plans were personalised, contained people’s preferences and were reviewed monthly. People were offered a variety of activities to meet their social needs. Care plans included people’s communication needs. The provider kept a record of complaints and these were used to make improvements to the service. People had their wishes documented for end of life care.

People, relatives and staff gave positive feedback about the leadership in the service. The provider had a system in place to receive feedback about the service from people using the service, relatives and staff so they could use these to make improvements to the service. People, relatives and staff had regular meetings, so they could be updated and give their views about the development of the service. The provider had quality audit systems in place to identify areas for improvement. The service worked in partnership with other agencies to make improvements to the service.

We have made one recommendation about the refurbishment of the building.

Further information is in the detailed findings below.