Ogwell Grange Residential Care Home

Updated 6 April 2023

The inspection

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

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.

Service and service type

Ogwell Grange is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ogwell Grange is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received since our last inspection and asked the local authority for feedback. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and spent time making observations in the communal areas on both days of inspection. We spoke with 16 people’s relatives and 9 members of staff, including the provider, registered manager, operations manager, deputy manager, care and domiciliary staff. We sought feedback from 6 healthcare / external professionals and received feedback from 2. We reviewed 3 people’s care records in detail and sampled 13 people’s care records. We reviewed a range of records including 3 staff recruitment files, records relating to training and supervision, safety of premises and equipment, safeguarding and governance.

Updated 6 April 2023

About the service

Ogwell Grange Residential Care Home (hereafter Ogwell Grange) is a residential care home on the outskirts of Newton Abbot providing personal care to up to 20 people. The service provides support to older people some of whom were living with dementia. At the time of our inspection there were 16 people using the service. Accommodation is provided over two floors with the first floor accessible by passenger lift and stair lift. Communal space included a dining room, lounge and conservatory, with views over the communal grounds and countryside beyond.

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

Systems and processes were in place to safeguard people, however, allegations of abuse were not always shared with the local authority or notified to CQC. In 2022, an allegation of abuse had been made. The registered manager took appropriate action and investigated the allegations; however, they did not share these with the local authority or CQC at the time. This was because their own investigation did not substantiate abuse had taken place.

We recommended the provider ensured all allegations of abuse are shared with the local authority and notified to CQC without delay.

Staff told us they felt confident the registered manager took allegations of abuse seriously and would act on them. The registered manager assured us they would share any future allegations with both the local authority and CQC.

Systems were in place to ensure staff were recruited safely, however, a full employment history was not always obtained and reasons for gaps in employment were not recorded. The registered manager addressed this immediately and made changes to their recruitment system to ensure this information is obtained in future. Pre-employment checks including obtaining employment references and Disclosure and Barring Service checks were obtained prior to staff starting work and there were enough staff to meet people’s needs. The atmosphere was relaxed and unhurried on both days of inspection and we observed staff had time to spend talking with people.

DoLS applications had been made where people lacked capacity to consent to care and treatment, however, mental capacity assessments had not always been completed prior to making the application. This was because there was some confusion about who’s responsibility it was. This was addressed immediately after the first day of inspection and good quality mental capacity assessments were put in place. None of the decisions or restrictions in place changed as a result of these assessments. By the end of this inspection, we were assured 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.

People’s relatives felt confident people’s risks were being monitored. One told us, “I like that the place is secure, so I know despite [relative’s] severe dementia, they are safe and well looked after there.” Risks were assessed and regularly reviewed and people’s care plans contained good information about how staff could minimise people’s risks. People received their medicines safely. Premises risk assessments were in place and equipment was well maintained. We were assured the provider had good systems in place to minimise the risk of infection.

People’s relatives gave positive feedback about the care people received. People’s needs were assessed, and care plans contained detailed and person-centred information. People were supported to eat a balanced diet and we received positive feedback about the quality of the food. We observed people were cared for in line with their personal preferences including their preferred choice of clothing and what was important to them. People told us staff were able to meet their needs and we observed warm interactions between staff and people. One person said, “The staff are pretty good, very caring.” Another person said, “They’re absolutely brilliant.” Staff had completed training relevant to their role and were supported with regular supervision. Staff worked effectively with other agencies and supported people to access healthcare services.

Staff were clear about their responsibilities and good systems were in place to ensure good governance both at registered manager and provider level. The culture of the home was person-centred, and people were supported to achieve good outcomes. One person’s relative told us, “I live locally, and their reputation has always been outstanding. They provide an excellent quality of care, and they give it with compassion. It’s like a family there.” A visiting professional told us, “They provide a caring, warm and easy-going atmosphere. There is a sense of people being at home here, of familiarity amongst residents and staff, of friendships, of people's difficulties being recognised and tolerated unless needing intervention.”

People were encouraged to be involved and give feedback both informally and through resident meetings. Senior staff described a culture where they were encouraged, and felt safe, to challenge each other and reflect on their own performance using models of practice designed to support professional and personal development. One member of staff told us, “I think this is one of the best homes I’ve ever worked In. They’re always looking to improve things.”

The provider was active in the local care industry and spent time engaging with the local authority and other providers to drive improvement. Their commitment to continuous learning and improving care not only in their own homes, but across the county, demonstrated a strong commitment to improving outcomes for people using services.

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 (28 March 2018).

Why we inspected

The inspection was prompted in part due to concerns received about protecting people from the risk of harm, poor moving and handling, staff competency, complaints, and the culture of the service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ogwell Grange Residential Care 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.