Kesteven Grange

Updated 11 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on the 31 August 2017. It was undertaken by two adult social care inspectors and an inspection manager.

Before the inspection we reviewed information we held about the service. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We spoke with the local authority safeguarding and commissioning teams about their views of the service. We also checked our systems for notifications, which the provider is required to submit to us. They tell us how the provider manages incidents and accidents for the people in their care.

During the inspection, we spoke with three people who used the service, four relatives, four members of staff and three visiting professionals. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed how staff interacted with people who used the service throughout the day and over the lunchtime period.

We reviewed the care records of five people who used the service and their medication administration records (MARs). We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held to make important decisions on their behalf.

We saw documentation relating to the running and management of the service including maintenance certificates for equipment, accident and incident records, meeting minutes, quality assurance tools, safeguarding records, complaints and compliments, environmental risk assessments, menus and business continuity arrangements.

We looked at five staff files, which included induction, training and supervision records and recruitment procedures. We completed a tour of the building to look at the environment.

After the inspection, we asked the provider to send us further information relating to the deprivation of liberty safeguards (DoLS) applications, appointee information for people who used the service and care plans. The provider sent this information by the agreed date.

Updated 11 October 2017

Kesteven Grange was last inspected on the 11 August 2015 and was rated Good. This inspection took place on the 31 August 2017 and we found the service remained Good.

Kesteven Grange is a purpose built home situated within a residential area in north Hull. It is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for 54 older people who may be living with dementia. Accommodation was provided over two floors and the first floor mainly housed people who were living with dementia. At the time of our inspection, the service was providing accommodation to 49 people used the service.

The service had a registered manager. 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.

People who used the service were protected from harm. The provider had safeguarding policies and procedures in place to keep people safe. Staff knew how to safeguard people from the risk of abuse and had received training.

Staff were recruited safely and we saw appropriate checks had been completed. The induction process for new members of staff was well established and thorough. Training was linked to the Care Certificate. The Care Certificate is a set of minimum national standards that health and social care workers should work to. The provider had put checks in place to assure themselves of the competency of staff and also reviewed staffing levels on a regular basis to ensure that the needs of people who used the service, were met. Staff received annual appraisals and regular supervision in accordance with the provider’s policies.

We saw the provider had systems and processes in place for the safe handling of medicines. We found minor recording issues, but were assured by the registered manager that these would be addressed immediately.

Staff supported the dietary needs of people who used the service. People were given a choice of foods, which catered to people’s preference and nutritional requirements. People who used the service told us there were always drinks and snacks available. Feedback on the menus was sought through meetings and questionnaires. Staff told us that the menu was regularly updated using this feedback.

We observed people were treated with dignity and respect. Staff behaved in a professional manner and told us they enjoyed their work. There were positive comments from people who used the service, their relatives and visiting health and social care professionals about the registered manager and staff team.

People who used the service 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. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and best interest meetings had taken place as required.

Personalised care was delivered through individualised care plans and risk assessments. Relatives of people who used the service told us they were involved in the care planning process. We found referrals to relevant community healthcare professionals had been made in a timely way.

People were supported to access activities in both the service and the local community. An activities co-ordinator provided a variety of activities such as arts and crafts and singing. Good links with the local community had been established and the provider had plans to expand these further in the next 12 months.

The records showed complaints were taken seriously and the outcome was followed up. People told us they knew how to complain and were sure their complaints would be addressed.

There was a quality monitoring system in place, which consisted of audits, checks, and obtaining people’s views. Surveys and meetings were carried out and the results used to drive improvement. The registered manager held a monthly surgery so that people could express their views and opinions. We saw that minutes of these meetings had been taken and feedback given.

The provider recognised the work of staff through recognition award schemes. People who used the service and their relatives were involved in this by being able to nominate members of staff for awards.

Further information is in the detailed findings below.