Background to this inspection
Updated
4 March 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of two inspectors, an assistant inspector and an Expert by Experience. This is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type
Gracewell of Sutton is a ‘care home’. 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed the information we held about this service including notifications the provider is required by law to send us about events and incidents involving people. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five people using the service, three relatives and a visitor. We asked them about their experiences of the care and support provided at the service. As most people using the service were unable to speak with us due to their communication needs, we observed interactions between people and staff.
We spoke with the senior management team including the registered manager, the deputy manager, the regional manager and the quality business partner. We also spoke with nine members of staff including a registered nurse, two senior care support workers, three care support workers, the activity coordinator, the chef and the person responsible for maintenance at the service.
We reviewed a range of records. This included five people's care records, medicines administration records (MARs) for five people, three staff recruitment files, staff training and supervision information and other records relating to the management of the service.
Updated
4 March 2020
About the service
Gracewell of Sutton is a nursing care home which can support up to 83 people in one adapted building. The services specialises in supporting older people living with dementia. At the time of this inspection 55 people were using the service.
People’s experience of using this service and what we found
People said they were safe at the service. Staff had been trained to safeguard people from abuse. They knew how to manage and minimise identified risks to people. The provider carried out health and safety checks of the premises and equipment to make sure they were safe. The premises were clean and tidy. Staff followed current practice which helped reduce infection and hygiene risks at the service.
There were enough staff to support people safely. Managers checked that staffing levels were meeting people’s needs at all times. Staff told us they would benefit from extra support at busy times. Managers were reviewing current arrangements to check these were continuing to support staff to provide high quality care to people at these times.
People preferred to receive care and support from permanent members of staff. The provider was recruiting more new permanent staff which would help reduce the use of agency staff at the service. The provider carried out checks on new staff, prior to them starting work, to make sure they were suitable to support people.
People and their representatives were involved in planning and making decisions about the care and support they needed. People’s records gave staff information about the care they required. This helped staff deliver support which met people’s needs. Staff knew people well and understood how their needs should be met.
Staff were kind, caring and enthusiastic about supporting people to achieve positive outcomes. Interactions between people and staff were warm and friendly. Staff provided comfort and support when people needed this. However, during the lunchtime service some staff had not been as attentive as they could have been to people’s needs. Managers undertook regular observations of mealtimes and no concerns had been identified from their most recent checks. They agreed to undertake further checks and remind staff of the standards expected during mealtimes.
Staff supported people in a dignified way which maintained their privacy and independence. 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 to be healthy and keep well. People were helped to eat and drink enough to meet their needs and to take their prescribed medicines. People had mixed views about the quality of meals they ate. Managers told us a new chef had been appointed for the service and hoped this would address some of the concerns people had. People were able to access healthcare services when needed. Staff worked well with other healthcare professionals and acted on their recommendations to make sure people achieved positive outcomes in relation to their health and medical conditions. When people became unwell, staff sought help for them promptly.
People participated in a wide range of activities and events at the service. They were supported to build and maintain social relationships with others and the people that mattered to them. There were a range of comfortable spaces around the premises where people could spend time in, when not in their room. Since our last inspection the provider had redesigned some areas of the service to encourage people to come together and take part in social activities. This helped people feel more socially included.
People and their representatives knew how to make a complaint if they needed to. Managers made sure any accidents, incidents and complaints were fully investigated and people informed of the outcome. Learning from investigations was acted on and shared with staff to help them improve the quality and safety of the support they provided.
Since our last inspection the provider had appointed a new registered manager and deputy manager for the service. They interacted with people well. However, some staff had mixed views about them. Managers were aware of staff’s views and were actively looking at ways to help staff feel more valued and rewarded.
People, their representatives and staff were provided opportunities to have their say about how the service could improve. Managers acted on their feedback and made the improvements that people asked for. Changes and improvements were only made if these did not impact on the quality of care and support provided to people.
Managers undertook checks at regular intervals, to monitor, review and improve the quality and safety of the service. They addressed any issues found through these checks, promptly.
Managers understood their responsibility for meeting regulatory requirements. They worked proactively with other agencies and acted on their recommendations to design the care and support provided to people. There were good links with the local community.
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 August 2017).
Why we inspected
This was a planned inspection based on the previous rating of good.
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.