Falkland Grange Care Home

Updated 22 September 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors 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.

Service and service type

Falkland Grange Care Home is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Falkland Grange is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of the inspection the registered manager was on leave, so the inspection was facilitated by the deputy manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed notifications and information we had received about the service since the last inspection. We sought feedback from the local authority, safeguarding team and other professionals who work with the service. We checked information held by the fire and rescue service, Companies House, the Food Standards Agency and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who use the service and six relatives of different people. We spoke with 24 staff including the deputy manager, night manager, nominated individual, head chef, one nurse, three team leaders, two seniors, eight care assistants, two wellness and leisure staff, the maintenance technician and three housekeepers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We observed care during mealtimes, social activities and medicine administration rounds to help us understand the experience of people who could not talk with us. We reviewed a range of documents, including four people’s care records, multiple medicine records and daily notes. We looked at six staff files in relation to recruitment, staff training and supervision. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures, accidents and incidents and quality assurance audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with six health and social care professionals who engaged with the service and the registered manager, on their return form leave.

Updated 22 September 2022

About the service

Falkland Grange Care Home is a residential care home providing personal and nursing care for to up to 64 people. The service provides support to older people and younger adults who may also have dementia. At the time of our inspection, there were 52 people using the service. Falkland Grange Care Home is purpose built to support the delivery of care to older people and those living with dementia. The service is set across two floors, comprising individual rooms with en-suite facilities. The home has spacious external and internal communal areas, to encourage social interactions, including dining rooms, lounges, a fitness studio, cinema, coffee bistro and hairdressing salon.

People’s experience of using this service and what we found

Staff understood their responsibilities to raise and record safety incidents, concerns and near misses, and to report them internally and externally where required. The provider took prompt action to address lessons learned as a result of reviews when things went wrong. We have recommended management staff complete additional training to support their analysis and investigation of incidents.

People experienced safe care and were protected from avoidable harm by staff, who had completed safeguarding training and knew how to recognise and report abuse. Staff assessed risks to people and managed them safely. Enough staff with the right mix of skills delivered care and support to meet people’s needs. Staff underwent a robust recruitment process to assure their suitability to support older people. People received their medicines safely from staff who had been trained and had their competency regularly assessed, in accordance with best practice guidance. Staff maintained high standards of cleanliness and hygiene in the home, which reduced the risk of infection.

Staff assessed all aspects of people’s needs and ensured these were met to achieve good outcomes. Staff were supported to develop and maintain the required skills and knowledge to support people effectively, according to their needs. Staff understood the importance of eating and drinking well and reflected best practice when supporting people to maintain a healthy balanced diet. Staff worked effectively with healthcare professionals to ensure people’s care met their changing needs. People were supported to make decisions about their care and these choices were respected by staff. Staff knew how to comfort and reassure different people when they were worried or confused. People received information in a way they could understand and process, allowing for any impairment, such as poor eyesight or hearing. People were enabled to live as full a life as possible and were supported to take part in imaginative activities, which enriched the quality of their lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The management team promoted a strong caring, person-centred culture where people and staff felt valued. Staff were passionate about their role and placed people at the heart of the service. The management team understood their responsibilities to inform people when things went wrong and the importance of conducting investigations to identify lessons learnt to prevent reoccurrences. The registered manager effectively operated robust measures to monitor quality, safety and the experience of people and staff to drive continuous improvement of the service.

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 (report published 30 April 2021).

Why we inspected

We received concerns in relation to a closed staff culture, insufficient staff, falls management, unsafe care and treatment, failure to record and report accidents and incidents to relevant authorities. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Falkland Grange Care Home on our website at www.cqc.org.uk.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.