Background to this inspection
Updated
17 January 2018
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 last inspection took place on 22 April 2015 and the service was rated ‘Good’ overall, but rated "Requires Improvement" in the safe domain. This unannounced inspection took place on 27 November 2017, and the service was rated ‘Good’ in all areas: "Good" overall.
Cuerden Grange Residential Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The inspection was carried out by one inspector, a Specialist Advisor and an Expert by Experience. A Specialist Advisor is a health and social care professional with particular expertise, who can advise on their findings during and following an inspection. In this case the Specialist Advisor was a nurse with expertise in the care of older people, and people experiencing mental health issues. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service, in this case older people and people living with dementia.
Before our inspection we contacted two visiting health and social care professionals in relation to the care provided at the home. During our inspection we spoke with the registered manager, nine members of staff, eleven people living at the home and five visiting relatives.
We looked at the provider’s records. These included five people’s care records, six staff files, a sample of audits, satisfaction surveys, staff attendance rotas policies and procedures.
We also checked the building to ensure it was clean, hygienic and a safe place for people to live.
We asked the provider to complete a Provider Information Return (PIR) before our inspection. 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.
Some people were not able to verbally communicate their views with us or answer our direct questions. 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 with us.
Updated
17 January 2018
Cuerden Grange Residential Home provides accommodation and personal care for up to 67 older people. Accommodation is provided on two floors. A passenger lift provides access to both floors. At the time of the inspection there were 57 people accommodated in the home. This unannounced inspection took place on 27 November 2017, and the service was rated ‘Good’ in all areas: "Good" overall.
The service had a registered manager. 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.
At the last inspection in April 2015, the service was judged to be in breach of the Regulations for infection control and recruitment. The home had made improvements since our inspection in April 2015. We had previously identified concerns which posed a risk of infection, for instance the kitchen on the first floor was in a poor state of repair and people were sharing hoist slings. These issues had been addressed. New kitchen surfaces had been provided or thoroughly cleaned, people no longer shared slings. This meant the risk of cross infection was reduced.
We also found that improvements had been made in relation to safe staff recruitment practices. The policies and procedures were now up to date, and recent recruitment had been undertaken in accordance with the Regulations.
Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles. Training records showed that staff had received training in a range of areas that reflected their job roles. The provider operated safe and effective recruitment procedures. Medicines were stored and administered safely.
The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies. People said that they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or manager.
Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were knowledgeable about strategies in place to keep people safe. There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support this was delivered quickly.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.
People and where appropriate their relatives were involved in their care planning, Staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed to check they were up to date.
People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.
People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.
The registered manager was supported by the service provider who was regularly in the service and who carried out a programme of quality assurance audits to identify areas of risk, and areas to maintain performance and drive improvement. The service had an open culture where people had confidence to ask questions about their care and was encouraged to participate in conversations with staff. Staff interacted with people positively, displaying understanding, kindness and sensitivity.