The Granby

Updated 16 November 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

This inspection was undertaken 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

The Granby 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. The Granby 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a new registered manager had been recruited and the recruitment process was ongoing. The regional support manager was currently managing the home.

Notice of inspection

This 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 and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 7 relatives about their experience of the care provided. We spoke with 3 members of staff including the regional manager, regional support manager and deputy manager.

We conducted a tour of the service and looked at a wide variety of records. These included multiple care and medicine records, monitoring documentation, staff files and audits used to monitor the service.

Following the inspection site visit we request some documents electronically. These included meeting minutes and audits. We also contacted 10 members of staff via email to request feedback on the service and support they received. We received responses from 3 members of staff.

Updated 16 November 2022

About the service

The Granby is a large nursing home providing personal and nursing care for up to 82 people, aged 65 and over. At the time of the inspection there were 47 people living at the service. The care home is set across three floors serviced by a lift.

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

Improvements had been made since the last inspection. Governance systems were now in place and effective in monitoring the quality and safety of the service. Action had been taken where shortfalls had been identified.

Risks in relation to the environment were now assessed and action had been taken to ensure risks were mitigated where possible. People had individual risk assessments in place that had been regularly reviewed and updated when changes occurred.

Medicines were stored, administered and recorded safely. Guidance for staff was now in place for medicines that were prescribed as and when required.

Improvements had been made with regards to the deployment of staff. Progress had been made with recruitment which had resulted in a reduction in the use of agency staff. Some people reported having to wait for support at busy periods. We have made a recommendation in relation to monitoring and auditing of call bell response times.

Staff had been recruited safely. People told us they felt safe living at the service and spoke highly of the staff team.

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 were supported to be involved in making decisions about their care and support.

The regional support manager had spent time working closely with the staff team to help build a positive and inclusive culture. People, relatives and staff were encouraged to provide feedback on the service provided. Action had been taken to address any issues raised.

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 (published 10 June 2021).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 carried out an unannounced focused inspection of this service on 26 April and 4 May 2021. 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 assessment of risk, deployment of staff and governance systems and processes.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

Follow up

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