Gretton House

Updated 14 May 2022

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

Two Inspectors, a member of the CQC medicines team and an Expert by Experience carried out the inspection. 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

Gretton House 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. Gretton House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and 10 relatives about their experience of the care provided. We received feedback from 15 members of staff in person and via email including the registered manager, area manager, deputy manager, team leaders, support staff, kitchen and domestic staff.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance audits, supervision and training records, meeting minutes, policies and procedures were reviewed. We received email feedback from four professionals who work with the service.

Updated 14 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Gretton House is a residential care home providing care and support to 15 people at the time of inspection, most of whom live with Prader-Willi Syndrome, a rare and complex genetic condition. The service can support up to 20 people.

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

Right Support

Staff supported people to have the maximum possible choice, control and independence and they had control over their own lives. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

The service worked with people to plan for when they experienced periods of distress. An inhouse behaviour specialist supported people and staff develop strategies to manage and reduce distressed behaviours. These were recorded in positive behaviour support plans where needed.

People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. People were supported to attend GP and other appointments independently or with support depending on their preferences and abilities. Staff supported people to make decisions following good practice in decision-making. Staff communicated with people in ways that met their needs.Staff supported people with their medicines in a way that promoted their independence and achieved the good health outcomes.

Right Care

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Recruitment was ongoing to fill vacancies. Staff received training and support appropriate to their roles.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability or Prader-Willi Syndrome may have. This meant people received compassionate and empowering care tailored to their needs.

Staff placed people’s wishes, needs and rights at the heart of everything they did. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff ensured risks of a closed culture were minimised so people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Follow up

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