Attleborough Grange

Updated 1 April 2023

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 2 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

Attleborough Grange is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Attleborough Grange is a care home without 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 our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service, an independent advocacy service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider had completed a Provider Information Return (PIR). A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 6 people who lived at home and 10 of their relatives. We carried out observations in communal areas to help us understand the experience of people who could not talk with us.

We spoke with 13 members of staff including the registered manager, the area manager, 2 care co-ordinators, 6 care staff, the lifestyle coach, the chef and a member of the housekeeping team. We spoke with two external healthcare professionals for feedback on their engagement with the service. We reviewed 6 people's care records and 3 people’s medicines records. We also reviewed records relating to training, recruitment and quality assurance.

Updated 1 April 2023

About the service

Attleborough Grange is a 'care home', which provides accommodation and personal care for up to 32 older people, some of whom are living with dementia. The home has two floors, with four 'households' – Abbey and Newdegate are on the ground floor and Chilvers and Griff are on the first floor. People had their own bedrooms, some of which had en-suites. People had access to communal lounge and dining areas and an outside garden area. At the time of our inspection there were 28 people living at Attleborough Grange.

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

There was a momentum for improvement within the service which meant previous breaches of regulations had been met. The provider had systems and processes to audit the quality of the service provided and any improvements identified had been incorporated into a service improvement plan. However, some checks needed to be more robust, for example medication audits and checks of care and risk management plans.

There were enough staff to provide safe and effective care. Staff were recruited safely and understood the action to take if they had any concerns or suspected abuse was taking place. Risks to people’s health and well-being had been identified and there was detailed guidance for staff on how to mitigate those risks. However, some identified risks were not always managed in line with people’s care plans.

The provider had policies and procedures to minimise the risks of an infection outbreak which were understood by staff. People’s medicines were available to them, but some improvements were required in the checks to support safe medicines practices.

Staff received appropriate training, support and supervision to carry out their roles effectively. People were encouraged to eat and drink enough to maintain a balanced diet. Where people had specialised diets, this was known by staff. People were referred to other healthcare professionals in a timely way and communication of information was effective. Improvements had been made to the environment which had a positive impact on the well-being of people living in the home.

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.

People and relatives were positive about the caring attitude demonstrated by staff. Staff enjoyed their work and were motivated to provide people with a warm and caring environment. Staff promoted privacy and independence and respected people’s individual beliefs and values.

Care plans considered all aspects of people's care and included their care preferences in relation to their health, emotional and social well-being. People were offered regular opportunities for social engagement either in group settings or one to one to prevent isolation or loneliness. People’s communication needs were assessed and supported. People were supported to stay at Attleborough Grange as their health deteriorated. Care plans contained some information about people’s wishes for their end of life care.

The culture of the service had improved, and staff felt able to raise concerns and share suggestions, confident they would be listened to. Managers were visible and supportive, and relatives were well informed about what was happening in the home. The provider supported staff well-being and had introduced initiatives to develop working relationships and improve outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (5 November 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We previously carried out an unannounced comprehensive inspection of this service on 14 October 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing levels, compliance with the Mental Capacity Act 2005 and the good governance of the service.

We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.

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.

We have found evidence that the provider still needs to make some improvements. Please see the safe and well-led sections of this full report. The overall rating for the service has remained requires improvement following this inspection.

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

Follow up

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