Scarsdale Grange Nursing Home

Scarsdale Grange Nursing Home is a residential care home providing personal and nursing care to up to 52 people. At the time of our inspection there were 49 people using the service.

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

The provider had a system in place to safeguard people from the risk of abuse. Staff received training in protecting people from abuse. Risks associated with people's care had been identified and guidance was in place to ensure staff provided safe care. Medicines were managed in a safe way. The provider had procedures in place to ensure people were protected from the risk and spread of infection. The home was clean and tidy.

Accidents and incidents were recorded, and the home manager completed an analysis to ensure trends and patterns were identified and action taken to mitigate future risks. Health and safety checks of the building and equipment were maintained.

The providers recruitment policy ensured staff were recruited safely and pre-employment checks were carried out. There were enough staff available to respond to people in a timely way.

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.

We observed staff interacting with people and found they provided person centred care and support. People were offered choices and given the opportunity to express their views.

Audits were in place to ensure the service operated to the standards expected by the provider. Where issues had been identified, action plans were devised, and items actioned in a timely way.

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 good (published 02 August 2017).

Why we inspected

We received concerns in relation to quality of care, staffing and safety. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Scarsdale Grange Nursing Home 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.

We found the following examples of good practice.

The provider had reviewed their infection prevention and control (IPC) policies. Staff were regularly updated with changes to government guidance and procedures to follow to keep people, staff and visitors safe.

Staff completed IPC training and were observed to be wearing the correct personal protective equipment (PPE) and following best practice.

People, visitors and staff were tested regularly in line with government guidance. People and staff were supported to self-isolate as appropriate. The registered manager monitored staff test results to ensure they returned to work only when they were able to do so.

The service was meeting the requirement to ensure non-exempt staff and visiting professionals were vaccinated against COVID-19.

The home was clean and hygienic throughout. Staff had access to cleaning products and cleaning schedules were in place. The registered manager completed infection control audits to ensure the home remained clean and well maintained.

The manager had started managing the service in February 2017 and had applied to register with the Care Quality Commission. 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.’

Scarsdale Grange Nursing Home is registered to provide accommodation and nursing care for up to 52 people. It is a purpose built care service. At the time of our inspection 48 people were living at the service.

People we spoke with told us they felt ‘safe’ and did not have any worries or concerns. Relatives we spoke with felt their family member was in a safe place.

Systems were in place to manage people’s medicines. We saw that the system in place to ensure medicines were stored at the right temperature required improvement.

Prior to inspection and shortly after the inspection we received some concerns relating to how people were supported to move. During the inspection we did not see any examples of people being supported inappropriately to move. The manager told us they were aware of the concerns and they were working with the service’s in house trainer to ensure staff followed the correct methods whilst supporting people to move.

Staff had undertaken safeguarding training and were knowledgeable about their roles and responsibilities in keeping people safe from harm.

There was a system in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This monitoring helps reduces the risks to people and helps the service to continually improve.

We did not receive any concerns from relatives or people using the service regarding the staffing levels at the service. Staff we spoke with told us the manager had improved the staffing levels at the service since they had started working there. During the inspection staff responded to people’s calls for assistance in a timely manner

People we spoke with were satisfied with the quality of care they had received. People’s comments included: “I like living here,” “It’s smashing here. I can’t fault it” and “They [staff] go out of their way to make you comfortable.”

In people’s records we found evidence of involvement from other professionals such as doctors, opticians, tissue viability nurses and speech and language practitioners. This showed that people had access to healthcare professionals to support their health.

Relatives we spoke with were satisfied with the quality of care their family member had received. Some of the relatives we spoke with told us they would recommend the service.

People using the service and relatives we spoke with made positive comments about the staff and told us they were treated with dignity and respect.

During the inspection we observed staff giving care and assistance to people. They were respectful and treated people in a caring and supportive way.

Most people we spoke with were satisfied with the quality of the food that was provided at the service. People’s nutritional needs were monitored and actions taken where required. Preferences and dietary needs were being met.

We found people were cared for by suitably qualified staff who had been assessed as safe to work with people.

Staff had received a thorough induction and their training was regularly updated. We saw staff received appropriate support to enable them to carry out their duties.

The service promoted people’s wellbeing by providing daytime activities and trips outside the service had been organised for people to participate in.

We saw there was a robust process in place to respond to concerns or complaints by people who lived at the service or their representative.

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.

Relatives and people using the service we spoke with felt the service was well managed. Some relatives we spoke with said they had greater confidence in the new manager of the service and liked the introduction of uniforms for staff. One relative said “Extremely well run.”

Staff meetings took place to review the quality of service provided and to identify where improvements could be made.

During the inspection we found a few concerns relating to the completion of records. We shared these concerns with the manager. They assured us that appropriate action would be taken.

There were regular checks completed by the senior staff working at the service to assess and improve the quality of the service provided.

People using the service and their relatives that we spoke with were positive about the home.

People using the service told us that their opinions were sought so that they were involved in decisions and that they had a choice. We observed positive interactions between staff, people using the service and their relatives throughout the visit.

People using the service and their relatives told us that care and treatment was planned and delivered in a way that ensured people's safety and welfare and they were involved in their care. Some comments included 'The staff always tell me what's going on and ask me what I want to do. They do a good job.' and 'I've been involved with my care'.

All the people and relatives we spoke with said they had no concerns about abuse in the home. One person using the service told us 'I feel safe here. I would tell the staff if I didn't.'

We found that there were enough qualified, skilled and experienced staff to meet people's needs.

We found that there was an effective system to regularly assess and monitor the quality of service that people receive.