Archived: Gracewell of Fareham

Updated 11 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We decided to carry out the inspection following concerns which had been raised with us about the care and welfare of people at the home, and to follow up on a warning notice which was served following the last inspection in February 2017. The Commission served one warning notice for failing to ensure records in the home were clear, accurate and complete to inform the care people needed. The registered provider had failed to ensure systems were in place to effectively assess, monitor and mitigate the risks associated with peoples care.

This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, looked at the overall quality of the service, and provided a rating for the service under the Care Act 2014.

The inspection took place on 13 and 14 September 2017 and was unannounced. The inspection was carried out on day one by four inspectors, a specialist advisor and an expert by experience. On day two the inspection was carried out by two inspectors, a specialist advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we reviewed previous inspection reports and information we held about the service including notifications. A notification is information about important events which the service is required to tell us about by law. This Information helped us to identify and address potential areas of concern.

During the inspection we spoke with eleven people living at the home and seven visitors. We observed the care people received and the interaction between staff and people using the service.

We spoke with the registered manager and other provider support, five nurses, the clinical lead, three care staff, an activity coordinator and five housekeeping and kitchen staff. We looked at the care records and other associated documents for thirteen people. We also looked at a range of records relating to the management of the service such as accidents/incidents, staff recruitment and training, complaints, quality audits and policies and procedures. We requested some records to be sent to us. We received this information.

Updated 11 October 2017

We carried out an unannounced inspection of this home on 13 and 14 September 2017.

Gracewell of Fareham is registered to provide accommodation, nursing and personal care services for up to 89 older people and people who may be living with dementia or a physical disability. At the time of our inspection 68 people lived at the home. They were accommodated in a purpose built building consisting of three floors and six bungalows for people with greater independence. The ground floor accommodation was intended for people with less complex needs, people living with dementia were supported on the first floor and the second floor accommodated people with other, more complex nursing needs. Each floor was divided into two named wings. Each wing had a shared sitting and dining area and each floor had a larger, central shared area. The ground floor had a hair dressing salon and cafeteria.

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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in October 2016 we identified one breach of the Care Quality Commission (Registration) Regulations 2009 and two continuing breaches and one new breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued requirement notices and a warning notice. At this inspection we found there had been improvements and the regulations had been met.

People and visitors felt the service was safe. People looked comfortable, relaxed and happy in their home and with the people they lived with.

People were supported by staff who had a good understanding of how to keep them safe. All staff had undertaken training on safeguarding adults from abuse and displayed good knowledge on how to report any concerns. Staff were able to describe what action they would take to protect people from harm.

Staff had a good understanding of people's needs and spoke in a caring way about the people they supported.

There were sufficient numbers of staff to meet people's needs and to keep them safe. The provider had effective recruitment and selection procedures in place and carried out checks when they employed staff to help ensure people were safe. Staff were well trained and aspects of training were used regularly when planning care and supporting people with their needs and lifestyle choices.

Staff encouraged people to be independent and promoted people's choice and freedom.

The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005. People were supported where possible to make everyday choices such as what they wanted to wear, eat and how to spend their time. The manager was aware of the correct procedures to follow when people did not have the capacity to make decisions for themselves and if safeguards were required, which could restrict them of their freedom and liberty.

Care records contained detailed information about how individuals wished to be supported. People's risks were well managed, monitored and regularly reviewed to help keep people safe.

People were supported to take part in a range of activities inside the home and they reflected people's interests and hobbies.

People were supported to maintain good health through regular access to health and social care professionals, such as GPs and speech and language therapists. People's dietary needs and any risks were understood and met by the staff team.

Staff described the management as supportive and approachable. Staff were well supported through induction and on-going training.

There were systems in place to monitor the quality and safety of the service provided and to manage the maintenance of the buildings and equipment.