We carried out a review of the data available to us about Hall Grange on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hall Grange, you can give feedback on this service.
We found the following examples of good practice.
People were in regular contact with their families. Relatives were able to visit people in the communal garden and have window visits. People receiving End of Life Care and those with dementia struggling with lockdown had a nominated Essential Family Carer (EFC) that was allowed to visit them inside the home during lockdowns. Staff made sure visits were carried out in a safe way. When relatives were not able to visit, they kept in touch with people through video and telephone calls. Staff kept relatives regularly updated about people through emails, telephone calls and social media.
Staff screened all visitors to the service for symptoms of infection and gave them information about the safety procedures they should follow to ensure their safety and the safety of residents and staff. People and staff were tested for COVID-19 in line with current guidance. The service also tested the EFCs when testing staff.
All staff had been trained in infection prevention and control (IPC) and the use of personal protective equipment (PPE). There were designated areas for staff to don and doff PPE and hand sanitising and washing facilities were easily accessible to people, staff and visitors. There were COVID-19, PPE and hand washing information signs throughout the home. We observed staff followed current IPC guidance and practice throughout our visit. Staff only worked at this location and were cohorting to reduce the risk of spreading infection. This meant the same staff worked in the same units and did not spend time on the other units.
The home had two designated lead staff for IPC to make sure staff complied with current guidance and practice. Any concerns found during the registered manager's checks and IPC audits were acted on immediately.
The service's IPC policy was up to date and in line with current guidance. The service had plans in place to respond immediately and appropriately to an outbreak of infection to ensure the safety of people and staff.
The service had surveyed people's wellbeing and got people's feedback on the impact of COVID-19 and lockdown. The provider used the information to respond to people's concerns and needs and took targeted steps to improve people's experiences and wellbeing.
Further information is in the detailed findings below.
Hall Grange provides accommodation and personal care for up to 86 people across two wings. Each has separate adapted facilities including a lounge, dining area and fully accessible showers and assisted bathrooms available for people. All bedrooms have ensuite bathroom facilities and there is lift access to all floors. One of the wings specialises in providing care to people living with dementia. There is a central hub area, coffee shop and seating. There is also an activities room, hairdressing salon and spacious level garden to the rear of the home. 82 people were using the service at the time of our inspection.
People’s experience of using this service and what we found
People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. Where risks were identified, there was guidance on the best ways to keep people safe.
People told us staff were available when they needed them and they felt safe in their care. The provider undertook the correct recruitment checks to ensure staff were suitable for their role. Staff continued to receive ongoing training and support to keep their knowledge, skills and practice up to date.
The environment was clean and well maintained. People had the equipment they needed to meet their assessed needs. Health and safety checks were carried out to make sure the premises and equipment were safe.
People's needs were assessed, and care and support was planned in partnership with them, their families and the staff who knew them well. Staff had the information they required to meet people's needs. Care records were individual and kept updated with any changes in people’s health and wellbeing. People's end of life preferences and wishes had been considered.
People received the care and treatment they needed to keep healthy. They had access to appropriate health, social and medical support when it was needed. Medicines were managed safely and people received their medicines as prescribed.
People received person-centred care which was responsive to their needs. People's communication needs had been assessed and where support was required, staff knew their preferred ways of communicating.
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 told us staff were kind, caring, attentive and treated them with respect. They said staff respected their privacy and dignity and supported them to be as independent as possible.
There were varied social and leisure activities and people had opportunities to try new ones. Activities were meaningful and planned to meet people’s needs and preferences. Staff understood the importance of social interaction and ensured they offered people support and companionship when needed.
People and their relatives had opportunities to share their views and the provider listened to their feedback. Relatives knew how to raise concerns and told us they were confident to do so. Arrangements were in place to monitor, investigate and respond to complaints.
The registered manager had good oversight of the service and used effective systems to monitor quality and safety, keep checks on standards and develop the service. Where improvements were needed or lessons learnt, action was taken.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 October 2018).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Hall Grange is a 45 bedded purpose built home that provides residential care for older people. It is a new build property and accessible to people who use wheelchairs. Accommodation is provided on the ground and first floors with lounges and separate dining facilities on both floors and en suite bathrooms in all bedrooms. On the third floor there is a kitchen, large laundry room and staff office with passenger lift access to all floors. The ground floor consists of a central hub area, coffee shop and seating. There is also an activities room, hairdressing salon, administration and manager office. Some people use the service for respite care breaks. At the time of our inspection there were 40 people using the service.
There was a registered manager for the service. 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.
People using the service and their relatives told us they felt safe and well cared for at Hall Grange. Staff knew how to recognise and report any concerns they had about the care and welfare of people and how to protect them from abuse and harm. Where risks were identified, there was guidance on the ways to keep people safe. The service responded appropriately to allegations or suspicions of abuse.
The environment was safely maintained and people had the equipment they needed to meet their assessed needs. Individual bedrooms were personalised and furnished to comfortable standards.
The provider followed an appropriate recruitment process to check that staff were fit and suitable to work in a care setting. Staff received an induction and relevant training to support people with their care needs. This was followed by ongoing refresher training to update and develop their knowledge and skills.
The staff team had worked at Hall Grange for a number of years and knew people well. There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. Staff treated people who used the service and their guests with respect and courtesy. They were caring, patient and maintained people’s privacy and dignity.
People's needs were assessed and planned for and staff had personalised information about how best to meet their individual needs. People's wishes, preferences and beliefs were reflected in their care plans. There was information about people’s social relationships and they were encouraged to stay in touch with their families and receive visitors. Staff were responsive when people's support needs or circumstances changed and care records were updated appropriately.
People's care records recognised their rights and were person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. When people were at risk of poor nutrition or dehydration, staff involved other professionals such as the GP or dietician.
Medicines were managed safely and people had their medicines at the times they needed them. Care plans contained information about the health and social care support people needed and they were involved in making decisions about their care. Arrangements were made for people to see their GP and other healthcare professionals when they became unwell or required additional services.
There was an open and inclusive atmosphere in the service and the registered manager led by example. Staff had a good understanding of the ethos of the home and were clear about their roles and responsibilities.
People and their relatives felt involved in the way the home was run and were encouraged to express their views and opinions. They knew how to complain and make suggestions, and were confident their views would be acted upon.
The provider had good oversight of everything that happened at Hall Grange. Management and staff completed regular audits to check the quality and safety of the service. Where improvements were needed or lessons learnt, action was taken.