The inspection took place on 10 October 2016 and was unannounced.The Grange Rest Home is a residential care home providing accommodation for up to 26 people, some of whom are living with dementia and who may require support with their personal care needs. On the day of our inspection there were 21 people living at the home. The home is a large property situated in Hove, East Sussex. It has a communal lounge, dining room, conservatory and garden.
The home was the only home owned by the provider and the management team consisted of a registered manager and two senior care staff. A registered manager is a ‘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 home is run.
People were protected from harm and abuse. There were sufficient quantities of appropriately skilled and experienced staff who had undertaken the necessary training to enable them to recognise concerns and respond appropriately. People’s freedom was not unnecessarily restricted and they were able to take risks in accordance with risk assessments that had been devised and implemented. Results of a recent resident’s questionnaire contained a comment that stated, ‘I can come and go as I please’. People told us that they felt safe, one person told us, “I’ve definitely been safe here”. Another person told us, “I feel safe in here, when I need help, I get it quickly”.
People received their medicines on time and according to their preferences, from staff with the necessary training and who had their competence assessed. There were safe systems in place for the storage, administration and disposal of medicines. One person told us, “I get my medication when I should and they watch me taking them”.
People were asked their consent before being supported and staff had a good awareness of legislative requirements with regard to making decisions on behalf of people who lacked capacity. One person told us, “The staff do gain my consent when giving me care”. People and their relatives’, if appropriate, were fully involved in the planning, review and delivery of care and were able to make their wishes and preferences known. Care plans documented people’s needs and wishes in relation to their social, emotional and health needs and these were reviewed and updated regularly to ensure that they were current. One person told us, “I have had a review, several times”.
Staff worked in accordance with people’s wishes and people were treated with respect and dignity. It was apparent that staff knew people’s needs and preferences well. Positive relationships had developed amongst people living at the home as well as with staff. One person told us, “The best thing here is all the staff, I thoroughly enjoy being here”.
People’s health needs were assessed and met and they had access to medicines and healthcare professionals when required. One visiting healthcare professional explained that if people were unwell then healthcare professionals were contacted promptly, they told us “They are very knowledgeable about the people here, they know lots about them”. One person told us, “I feel so much better after being here”. People’s privacy and dignity was respected and maintained, one person told us, “They let me be on my own, I like it that way, they do help me in my room in private”. People had a positive dining experience and told us that they were happy with the quantity, quality and choice of food. One person told us, “The food is marvellous, the chef is so good, If I didn’t fancy the menu the chef would do something else for me”.
The registered manager welcomed feedback and used this to drive improvements and change. There were quality assurance processes in place to enable the registered manager to have oversight of the home and to ensure that people were receiving the quality of service they had a right to expect. People, relatives’ and staff were complimentary about the leadership and management of the home. One member of staff told us, “I think it is run really well. The registered manager is really passionate about the home, she really worries about the residents”. One person told us, “The manager is absolutely fabulous, she does a good job as manager, and she is approachable”. Another person told us, “The manager is very good, when she was away the residents’ missed her, I do think she is a good supporter of her staff, she runs it well. They all do a good job”.