Dystlegh Grange

Updated 17 July 2019

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 was carried out by one adult social care inspector, an assistant inspector and an Expert by Experience on the first day of the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of the inspection was completed by one adult social care inspector.

Service and service type

Dystlegh Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at the latest Healthwatch report. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted the local authority to ask for their views on the service. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with the registered manager, the care manager and senior care manager and four members of care staff. We spoke with eleven people living in the home and four of their relatives. We also spoke with two visiting health professionals. We looked at four people’s care records, three staff files, medication records as well as records relating to the management of the home. We looked around the home to ensure it was a clean and safe environment. We made observations of interactions between staff and people living in the home.

Updated 17 July 2019

About the service

Dystlegh Grange is a residential care home providing personal care to 29 people aged 65 and over at the time of the inspection. The home is registered for up to 40 people. Accommodation is provided in single suites which contain private kitchen facilities and en-suite bathrooms. 18 suites have separate lounge and dining areas. All suites have either balconies, outdoor space or Juliette balconies, enabling access to outdoor space or air.

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

Without exception, everyone we spoke to talked about the outstanding care and staff at Dystlegh Grange. Everyone was proud to live there and had actively chosen to move there. They felt a sense of purpose and led active and fulfilling lives due to the exceptional environment, support and approach of staff members. They felt in complete control of their care and able to contribute to the running of the home. Furthermore, they felt through some of the research that they were contributing to the care of the future. People’s experience was summed up by two people who said, “It is outstanding here. The standard of carers is the best thing” and “It’s like a five-star hotel. Excellent environment”.

Professionals also spoke extremely highly of the home and how the home was able to support people to have excellent outcomes. The exceptionally good record keeping enabled people to access primary healthcare services quickly and ensured excellent continuity of care and be supported until the end of their life extremely well in an individualised way.

Everything in the home was led by the people living there and staff saw their role as supporting people to live their life in a way they were happy with. One staff member summed it up, “Here is much more than a care home. It is a collection of people's individual homes.” Staff had excellent knowledge of people which enabled them to support people in highly individualised ways from finding activities which increased their emotional wellbeing, to encouraging mobility or supporting people with nutrition.

People felt very safe and that they were involved in all decisions within the home. They were supported to maintain their independence whilst being supported to take positive risks to live full and active lives. People had a say in the staff who worked in the home and who supported them.

Staff had access to excellent training. Champions had been identified to improve and build upon different areas of care by looking at best practice and how this could benefit people in the home. Both staff and people living in the home were champions. They had arranged helpful information sessions to people and sourced equipment, both of which had benefited people and their relatives.

The environment was designed to let in as much light as possible and connect people to one another and the external environment whilst providing space for privacy and quiet time. Suites were personalised and bespoke adaptions to suites were made to individual’s specifications either prior to them moving in or as their needs changed.

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 home supported this practice.

Strong relationships were formed between staff and people due to the continuity of staff and exceptionally caring approach of staff members. Everyone spoke of how staff went above and beyond to ensure that they were happy and comfortable in the home. One relative summed up many people’s comments. They said, “I am absolutely certain that my [relative] would not be here today if it was not for their excellent facilities, deep understanding of the needs of older people and true awareness of my [relative] as a person, this is supported by what I truly believe to be genuine friendship, which exceeds expectations.”

Activities were initiated and led by the people living in the home around their individual interests and preferences. They often would arrange clubs themselves or ask staff to support them to undertake activities. Outings were facilitated by staff as per people’s suggestions and people were encouraged and supported to continue activities outside the home as well as community involvement.

Any minor issues within the home were dealt with prior to becoming complaints, however everyone felt that their views were respected, and they could offer feedback on the home which would be respected and acted upon.

Relatives of people who had recently passed away described the staff as going above and beyond their expectations in terms of end of life care. One professional described the end of life care as exemplary. All staff were trained in end of life care and the home was accredited and prided itself on ensuring people had a very dignified and positive death.

The registered manager was also the company director and had been in post over 35 years. Their passion and commitment shone through every aspect of the home and was mirrored by their staff team. Professionals, staff, relatives and people living in the home spoke so highly of the care, compassion and dedication of the registered manager. Many people living in the home felt they were part of his family.

This commitment was shared by the whole staff team who strove to achieve excellence in all that they did in order that people living in the home received the best quality care. The comments received from people and relatives reflected that they had achieved this aim and vision.

The registered manager was driven to achieve excellence in all aspects of the home environment and care of people living there. They were part of numerous local initiatives, accreditation schemes and pilots as well as contributing to research. They attended all the local meetings and collaborations and were continually looking for improvements and how they could assist people to maintain a fulfilled and excellent standard of living.

The home was very open, had strong links and was integrated into the local community. It hosted several community events throughout the year and made rooms available for local charities. The home had made its defibrillator available to the local community, so the community always had access to one. ‘Friends of Dystlegh Grange’, were people who stayed on respite or relatives whose loved one had passed away, who continued to be invited back to the home to join in events and celebrations.

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 outstanding (published 6 December 2016)

Why we inspected: This was a planned inspection based on the previous rating.

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.