Archived: The Grange

The provider sent us an action plan which had been completed following our inspection. This included the action they were going to take to meet the regulations and the timescales within which these would be achieved.

We returned to inspect on 27 February 2014 to review whether the provider had made improvements. We found improvements had been made in all of these areas.

Some of the people we saw and spoke with during the inspection had complex needs, which meant they found it difficult to communicate with us. We observed how they interacted with the staff that supported them and they appeared content and happy in their company.

We found there were sufficient numbers of qualified, skilled and experienced staff to meet people's needs.

We found the provider had an effective system to assess and monitor the quality of service provision. This included a range of monitoring activities and seeking feedback from people who used the service.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. This included people's support plans and risk assessments being reviewed and updated on a regular basis and records being stored securely.

We returned to inspect on 6 August 2013 to review whether the provider had made improvements. We found improvements had been made in all of these areas.

We found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We found care files were well organised and it was relatively easy to gain an overview of people's needs. We also found some areas of care were more difficult to track.

We saw the provider had updated their recruitment procedure and saw staff recruited recently had been through the checks required before commencing employment. This included identity checks, police checks and the receipt of satisfactory employment and character references.

We found staff were supported in relation to their responsibilities. This included the provision of appropriate training and supervision.

In response to these concerns, we carried out an unannounced inspection on 19 April 2013 and 23 April 2013.

As part of this inspection we followed up on a compliance action set at the previous inspection in November 2012. We found improvements had not been made.

People we spoke with told or indicated to us they were happy with the care and support they were receiving. One person said 'It's the best move I've made' and 'I like the quietness here.' Although people said they felt supported and looked after, other evidence did not always support this.

The provider did not have effective recruitment and selection processes in place. There were not enough qualified, skilled and experienced staff to meet people's needs. Staff were not supported to enable them to deliver care and treatment safely and to an appropriate standard.

The provider did not have an effective system in place to regularly assess and monitor the quality of service people received.

People's personal records, including medical records, were not accurate and fit for purpose. We also found the providers policies and procedures required review and some records could not be located promptly when needed.

People told us they were happy with the care and support they were receiving. One person told us "They do look after me' and another person said 'I'm happy. I'm moving soon (to another flat at the location) and I'm so excited.' Although people told us they felt well looked after, other evidence did not always support this. We saw some of the actions set out in people's care plans had not been carried out.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider had safeguarding policies and a procedure in place.

People said they were happy with the staff and the care they provided. One person said the staff were 'Lovely ' they do a wonderful job' and another person said "I like (staff's name) ' they took me on holiday." We found sufficient staff were provided, however there was a lack of suitably experienced staff in post at North, East and West View to support people.

We saw the provider maintained appropriate records required for the protection of people who used services.