Background to this inspection
Updated
6 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 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.
This inspection took place on 17 January 2018 and was unannounced. The inspection was undertaken by one inspector.
Before our inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We also reviewed the provider information return (PIR) submitted to us 23 March 2017. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.
During the inspection we observed staff support people who used the service. We spoke with three staff members and two representatives of the provider’s senior management team. Subsequent to the inspection site visit we spoke with relatives of three people who used the service by telephone to obtain their feedback on how people were supported to live their lives.
We received feedback from representatives of the local authority adult disability service. We also 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 due to their complex health needs.
We reviewed care records relating to two people who used the service and other documents central to people's health and well-being. These included staff training records, recruitment records, medication records and quality audits.
Updated
6 February 2018
The inspection took place on 17 January 2018 and was unannounced.
Grange Care Services – Flamstead End Road 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.
Grange Care Services -Flamstead End Road is a small residential centre registered to provide accommodation without nursing and accommodates up to six adults with learning disabilities in one adapted building.
The service had a registered manager who was also registered with CQC to manage another Grange Care Services learning disability service locally. 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. The registered manager was not at the service on the day of this inspection however, support was provided by the area manager and a representative of the provider.
When we last inspected the service on 14 January 2016 we found that the provider was meeting the standards assessed at that time. However, at this inspection we found that well led was an area that required improvement.
The provider’s quality monitoring of the service had not identified areas of shortfall identified through this inspection and the management of the service was not always robust. Investigations into concerns raised with the service were not always robustly undertaken. CQC had not been notified of some incidents that had potential to affect people’s safety and well-being which meant we could not check that appropriate action had been taken. Satisfaction surveys were distributed annually to relatives of people who used the service and relevant professionals.
We were advised that there were regular networking meetings held for registered managers within the provider’s services to share good practice and explore ideas. However, the senior management team were not aware of updated sector guidance such as Registering the Right Support (RRS) which sets out CQC’s policy on registration and variations to registration for providers supporting people with a learning disability and/or autism. This Guidance discusses the impact of RRS on inspections of relevant existing services.
People’s demeanour indicated that they felt safe living at Flamstead End Road. Staff understood how to keep people safe. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.
Staff received regular one to one supervision from a member of the management team which made them feel supported and valued and received training to support them to be able to care for people safely. People received support they needed to eat and drink sufficient quantities and their health needs were catered for with appropriate referrals made to external health professionals when needed. Staff understood their role in protecting people's rights in accordance with the Mental Capacity Act 2005 (MCA).
People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people’s relatives had been involved in the planning of care where appropriate. Visitors to the home were encouraged at any time of the day.