At the time of our inspection 33 people were living at The Grange and Elm Court. An inspection was undertaken to help us answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who lived at the home, speaking with external health care professionals, speaking with the staff working at the home, talking to and reviewing information from other authorities and from looking at records at the service.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they supported.
People told us they felt their rights and dignity were respected.
The home had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The manager said there was one current application submitted under this legislation. Relevant documentation was in place and decisions made had involved all relevant parties. Staff received relevant training and were able to describe the MCA and when a DoLS application would be necessary. This meant that people were safeguarded appropriately in line with current legislation.
We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.
There were effective recruitment and selection processes in place. We checked staff files and found the provider maintained a rigorous recruitment process.
People who used the service were not protected against the risks of unsuitable premises because the premises were not adequately maintained.
Is the service effective?
People living at the home had access to advocacy services which meant when required, people could access additional support.
People's health and care needs were assessed with them and their representatives, and they were involved in writing their support plans.
Staff were provided with training to ensure they had the skills to meet people's needs. However some staff had not received adequate induction training when they commenced employment which meant that some staff may not have the skills to meet people's needs.
Is the service caring?
During our inspection we saw people seemed very comfortable in the presence of staff. We observed staff giving support to people throughout the inspection and they were respectful and treated people in a friendly and supportive way.
We spoke with people and they all confirmed they were happy with the care provided. They said, 'Overall I think we do well, I'm happy enough', 'the home's kept clean, staff take me out, they are good', 'staff are lovely' and 'It's good here, we get everything we need.'
Healthcare professionals we spoke with said 'The Grange and Elm Court provides a safe, effective and caring environment for people' and 'We have no concerns about the service, they do a good job.'
People's preferences and interests had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People completed a range of activities in and outside the service on a daily basis. People were assisted to access the community and attend day services, attend appointments at local health services and take part in day trips to places such as the coast and museums.
People knew how to make a complaint if they were unhappy and said they would tell the manager. They commented, "I would go and see the boss, I see her every day, I tell her if I am not happy, most things are sorted out OK.'
We saw people approach the manager and talk freely with them. It was positive to hear people being very vocal regarding any issues they wished to raise.
Is the service well-led?
The service worked with other agencies and services to make sure people received their care in a joined up way.
The quality assurance system at the home showed that identified health and safety shortfalls were being addressed as part of a service contingency plan. The manager had undertaken audits on people's individual rooms and some action had been taken to redecorate and in some instances re-carpet these rooms when needed. However there had been no formal audit relating to the overall aesthetics and general decor of the home.
Staff told us they were clear about their roles and responsibilities. Discussions on best practice, improved ways of working and incidents reviews were common throughout formal team meetings and informal discussions.