Background to this inspection
Updated
3 February 2018
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 inspection took place on 09 January 2018 and was unannounced.
The inspection was carried out by one inspector 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.
Before the inspection we gathered information about the service by contacting the local and placing authorities. In addition, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
As part of our inspection we spoke with 11 people and 1 relative. We also observed the care that people received and how staff interacted with people. We spoke with the registered manager, the deputy manager and 3 care staff. We read care plans for 3 people, medicines records and the records of accidents and incidents. We looked at mental capacity assessments and applications made to deprive people of their liberty.
We looked at 4 staff recruitment files and records of staff training and supervision. We saw records of quality assurance audits. We also looked at records of menus, activities and minutes of meetings of staff and residents.
Updated
3 February 2018
This inspection took place on 09 January 2018 and was unannounced. Our last inspection was in October 2016 where we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities 2014). These related to governance and the processes for obtaining consent from people. At this inspection, the provider had taken action to meet the requirements of the regulations.
Grace House is a residential home providing care and support to up to 21 older people. People living at the home had physical disabilities, frailty and some people were living with dementia. At the time of our inspection, there were 18 people living at the home.
Grace House 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.
There was a registered manager in post. 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 had access to a wide range of activities that were tailored to their interests. Staff took time to find out about people’s interests and identified activities based on these. People were complimentary about the food on offer at the home and the provider regularly asked people’s feedback on food, activities and the care that people received. Staff provided support to people in a way that respected their right to consent and in line with the legal process set out in the Mental Capacity Act 2005.
Care was planned in a person-centred way. People’s care plans contained important information about their needs and what was important to them. People’s wishes for end of life care were clearly documented. Where people faced individual risks, appropriate plans were implemented to keep them safe whilst promoting their independence. Staff supported people in a way that encouraged them to maintain and develop skills. People were regularly offered choice and involved in decisions about their care.
Staff supported people safely following incidents. Staff understood their roles in safeguarding and responded appropriately where they identified concerns. The provider analysed all accidents and incidents and responded to any trends that they found. The provider was open and transparent when dealing with relatives, healthcare professionals and CQC. Regular audits were carried out to monitor the quality of the care that people received.
People’s medicines were managed and administered safely, by trained staff. Staff supported people to access healthcare professionals whenever this was required. The provider had built links with local community organisations and agencies. People were supported by kind and respectful staff who were mindful of people’s privacy and dignity whilst providing care.
People were supported by staff that were trained to carry out their roles. Staff felt supported by management and had regular one to one meetings with their line managers and regular team meetings. Staff were able to make suggestions about the running of the home that led to improvements for people. There were clear leadership structures at the home and systems were in place to enable effective communication between staff.