This inspection took place on 2 and 3 August 2018 and was unannounced. The previous inspection was carried out on 20 and 21 June 2017, there had been several breaches of legal requirements at that time. We rated the service requires improvement in three of the key questions, safe, caring and well led. We found at this inspection significant improvements had been made since the last inspection. The registered manager had submitted an action plan to the Commission so that we could monitor the improvements made.There was a registered manager in post. 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 of the Health and Social Care Act 2008.
Granville Lodge provides accommodation for people who require nursing or personal care for up to 81 people. At the time of our visit there were 73 people living at the service.
People were protected from abuse because staff understood how to keep them safe, including understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.
There were enough suitable staff to meet people's needs.
People's safety had been considered by the service, risk assessments both for care and the environment had been completed.
Staff recruitment procedures were safe and the employment files contained all the relevant information to help ensure only appropriate staff were employed to work at the service.
People received their medicines when they required them and in a safe manner. Staff received training and guidance to make sure they remained competent to handle people's medicines.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 (MCA) and the DoLS. Staff had the right skills and training to support people appropriately.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People were supported to eat and drink according to their likes and dislikes. People's nutritional needs were reflected in care plans and we observed staff supporting people to ensure their health and wellbeing was maintained.
Staff were caring, kind and treated people with respect. Staff were described as caring by people's relatives. The registered manager and staff were held in high regard and we received positive comments about the service they provided.
People's personal and health care needs were met and care records guided staff on how to do this. There was a variety of activities for people to do and take part in during the day, and people had enough social stimulation.
The service supported people to maintain their health and wellbeing and people were supported to access healthcare services and any treatment required promptly.
There was a system in place for responding to and acting on complaints, comments, feedback and suggestions.
People and their relatives praised the management of the service. They said the team were approachable and had a visible presence at the service. The views of people and their relatives and staff had been actively sought to develop the service. Effective arrangements were in place for the service to learn, improve and assure its sustainability. Strong partnerships had been developed with other agencies for the benefit of people who used the service.
Quality assurance systems were in place to assess and monitor the quality of service that people received and identify any areas that required improvement.