The Grange - Benenden

Updated 22 April 2021

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.

As part of CQC's response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 24 March 2021 and was announced.

Updated 22 April 2021

This inspection was carried out on 25 and 27 September 2018 and was unannounced.

The Grange is a ‘care home’. People in care homes receive accommodation and 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 Grange is registered to provide accommodation and personal care for a maximum of 19 people. The home specialises in providing care to people with learning disabilities and the registered provider was taking steps to adapt it in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of our inspection there were 17 people living in the service. Accommodation is arranged over three floors.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 7 September 2017, we told the provider to take action to make improvements because Deprivation of Liberty Safeguards (DoLS) applications had not been made for people who needed support if they attempted to leave the service. At this inspection on 25 and 27 September 2018 we found the service had made improvements and staff were following the principles of the MCA. Applications for Deprivation of Liberty Safeguards were sent to the local authority when required, and senior staff ensured best interest meetings were held if people were not able to make their own decisions. Staff knew how to seek consent from people could, and were knowledgeable about the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were central to the support they received. Each person had their own care plan which had been reviewed taking into account their views and preferences. People were supported to take part in activities of their choosing and had a rich and varied social life. People were involved in deciding who they were supported by as they were involved in the recruitment processes. People said they knew how to complain, and would do so if the need arose. The registered provider was beginning to consider how they might support people at the end of their lives to have a dignified death by speaking to them about their preferences. They were doing this by working in collaboration with the person and health and social care professionals.

Staff had developed and maintained strong, caring and positive relationships with the people they supported. Staff were highly motivated to provide people with care in a compassionate way. Staff knew people well, and went out of their way to ensure people’s needs were central to any support provided. There was a reciprocity of kindness between people and staff due to the strong person-centred culture of the service. Staff had time to listen to people and encouraged them to be involved in deciding how their support was delivered. People were encouraged to be independent, and staff worked towards their goals. People had their privacy and dignity respected and promoted. People’s confidential information was kept private.

People were protected from the risk of abuse by staff who were trained in how to identify and report abuse. Staff felt any concerns would be taken seriously by their managers, and managers knew how to report abuse to the local authority. Risks to people and the environment were assessed, and staff took steps to reduce any risk identified. There were enough people on shift to meet the needs of people living at the service. New staff were recruited safely in line with best practice and nationally recognised guidance. People received their medicines in a safe manner. Staff received training and had their competency checked on a regular basis. People were protected by the prevention and control of infection. Steps were taken to ensure lessons were learned when things went wrong. The registered manager worked transparently with staff and external professionals during investigations.

People had their care and support delivered in line with current legislation and best practice guidance. Staff received training that was built around those using the service. People were involved in developing their own weekly menu. Some were involved in cooking meals. Staff sought and followed guidance from health professionals if people had difficult eating. People had access to health care and treatment. Staff support people to understand what any treatment was for. People’s needs were met by the design and adaptation of the premises.

The registered manager had the skills and experience to lead the service. The culture at the service was honest and transparent. Staff said they felt proud to work at the organisation. They had oversight of the daily culture in the service, which included the attitudes, performance and behaviour of staff. People, their families and staff were encouraged to be engaged and involved in the service. There were growing links with the local community.