Archived: Minster Grange Care Home

Updated 12 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was 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 was carried out on 13 and 14 June 2017 and was unannounced. This meant the provider and staff did not know we would be visiting.

On the first day of our inspection, the inspection team consisted of four adult social care inspectors, one Specialist Adviser in dementia and nursing care and one 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. During the second day of our inspection, the inspection team consisted of four adult social care inspectors.

Before our inspection, we reviewed the information we held about the service, such as safeguarding information and notifications we had received from the provider. Statutory notifications are when registered providers send us information about certain changes, events or incidents that occur. As part of the inspection planning process we contacted the local council for their feedback.

We did not ask the provider to complete a provider information return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection, we spoke with 12 people who used the service and 7 relatives who were visiting people.

We spoke with the business director, the manager, the deputy manager, an improvement director and 20 members of staff including nurses, senior carers, care assistants, the activities coordinator and a chef.

We were shown around the building and looked at communal areas and, with people's permission, their private bedrooms.

We observed interactions between staff and people who used the service throughout the inspection and during the evening on the first day.

We observed support provided in communal areas including planned activities and meal times and observed medication rounds on all floors at the home.

We 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 communicate directly with us.

We reviewed care records for 12 people who used the service, medication administration records, recruitment and training records for 11 staff and we looked at other records relating to the management of the service.

Updated 12 July 2017

This inspection was carried out on the 13 and 14 June 2017 and was unannounced.

Minster Grange Care Home is a residential and nursing home which provides accommodation for up to 83 people. The service supports disabled adults and older people, including people who have nursing needs or may be living with dementia.

The service is located in York, north of the city centre. Accommodation is provided across three floors each containing two units. On the ground floor, Ash provides nursing care and Aspen provides nursing care for younger adults. On the first floor, Beech and Briar provide nursing care for people who may also be living with dementia. On the second floor, Copper provides residential care for people who may be living with dementia and Chestnut provides residential care for older people.

All the bedrooms are en-suite and the service also has communal lounges, dining rooms and bathrooms on each floor. There is a safe garden and outside balconies on the upper floors for people to use. A car park is available for visitors.

There was a registered manager in post. 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 will be referred to as ‘manager’ throughout the report.

At the last inspection in November 2016 the provider was rated as required improvement. This was because they were in breach of five Regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in Regulation 10 Dignity and respect, Regulation 12 Safe care and treatment, Regulation 15 Premises and equipment, Regulation 18 Staffing and Regulation 17 Good governance.

We asked the provider to submit an action plan regarding the breaches identified and during this inspection the actions were met. No further breaches were identified during this inspection.

Systems and processes were in place that helped keep people safe from harm and abuse. Staff had completed safeguarding training and knew the signs of abuse to look out for and how to raise any concerns.

The provider ensured there were sufficient skilled and qualified staff to meet people's individual needs and preferences.

People received their care and support from regular staff that ensured continuity and consistency.

The provider had a robust recruitment process. Checks were completed that helped the provider to make safer recruiting decisions and minimise the risk of unsuitable people working with vulnerable adults.

Where people had been assessed as requiring assistance with medicines support, these were administered safely in line with their prescription. Systems and processes were in place to record the administration of medicines. Audits were in place to maintain standards and to identify any errors or omissions where actions would be taken.

The provider had systems and processes to record and learn from accidents and incidents that identified trends and helped prevent re-occurrence.

There were enough staff to meet people's needs. People received support from staff who showed kindness and compassion. People’s dignity and privacy was protected. Staff understood people's individual needs in relation to their care. Support plans were centred on the person and reflected individual's preferences.

People received care and support from staff that had the skills and knowledge to understand their role. Staff received regular documented supervision to ensure they were supported in their role and development. The provider completed competency checks and were implementing further checks to ensure staff remained competent to carry out their roles.

People were supported to pursue interests and activities of their choosing. They were supported by a dedicated team of activities co-ordinators and staff fully supported people with the programmes on offer.

We checked and found the service was working within the principles of the Mental Capacity Act 2005. Staff confirmed people were assumed to have capacity unless assessed as otherwise and were supported to make decisions. The manager and staff had an understanding of Deprivation of Liberty Safeguards. They had made appropriate referrals to the relevant authorities to ensure people's rights were protected.

People were supported to eat and drink healthily. Any specific dietary needs were recorded in their care plan and staff confirmed they requested support from other health professionals where it was required.

The provider had ways of involving people and their relatives and obtaining their suggestions for how the service could be improved. People who used the service had been involved in planning and reviewing the care provided.

There was an effective complaints procedure for people to raise their concerns.

There were systems of audit in place to check, monitor and improve the quality of the service. Associated outcomes and actions were recorded with timely outcomes and these were reviewed for their effectiveness. The provider worked effectively with external agencies and health and social care professionals to provide consistent care.

The provider, manager and staff were committed and enthusiastic about providing a person centred service for people.

Everybody spoke positively about the way the service was managed. Staff understood their levels of responsibility and knew when to escalate any concerns. The manager had a clear understanding of their role and responsibilities and requirements in regards to their registration with CQC.