Nicholl Grange

Updated 13 March 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Nicholl Grange is a care home. People in care homes receive accommodation and

nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did

Prior to the inspection we reviewed information we held about the service since their last inspection. This included notifications received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. We also contacted the local authority who commissioned services from this provider. They raised no concerns about the service.

During the inspection we spoke with four people, three members of staff, the deputy and registered manager.

We looked at the care and review records for one person who used the service. The management records for how people were administered medicines as well as a range of records relating to the running of the service. This included incident and accident monitoring as well as complaints.

Updated 13 March 2019

About the service:

• Nicholl Grange is a small care home providing personal care and accommodation for up to 14 people who have a mental health diagnosis. At this inspection 14 people lived within the service.

What life is like for people using this service:

• People continued to receive safe care. People were safe and staff knew how to keep them safe. The provider had enough staff to ensure people were supported safely and recruitment processes were in place to ensure appropriate checks were conducted before staff were employed. People took their own medicines and the provider had systems in place to monitor this was being done safely. Staff had access to personal protective equipment and Infection control guidance was in place. Accidents and incidents were noted so trends could be monitored to reduce the amount of accidents.

• People continued to receive effective care. Staff were supported and had the skills and knowledge required to meet people’s needs. 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 lived independently and made their own choices with support from staff as to what they had to eat and drink. People were supported when needed to attend health appointments.

• People continued to receive support when needed that was caring and compassionate. People were encouraged by staff to make decisions as to how they were supported. Staff were kind and caring and people’s privacy dignity and independence were promoted in the way staff supported them.

• People continued to receive support that was responsive to their needs. People’s support needs were assessed and a support plan showed how people wanted to be supported. People received support that was personalised and reviews took place. People lived independently and was able to do the things they wanted. The provider had a complaint process in place and people used it to share concerns they had.

• The service did not continue to be well managed. The registered manager did not ensure that quality assurance audits and spot checks were effective in identifying areas for improvement. The call bell system was not always accessible to people in an emergency. The provider did not consistently carry out quality assurance audits. Provider told us they used questionnaires to gather people’s views on the service, but was unable to provide evidence. The environment was welcoming, clean and tidy.

More information is in the Detailed Findings below.

Rating at last inspection:

• Rated Good (Report published 17/12/2015).

Why we inspected:

• This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.