Stanley Grange

Updated 20 March 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors, an inspection manager and an 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.

Service and service type

Stanley Grange is a combination of two ‘care homes’ and supported living service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us 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 11 people across the service, we asked them about their experience of the care provided. We spoke with the registered manager, the quality compliance lead, positive behaviour support lead, team leaders, deputy network managers, a service manager and the director for operations. We spoke with twelve staff and four visiting relatives.

We reviewed a range of records. This included six people’s care records, multiple medication records and accident and incident records. We looked at a variety of records related to the management and maintenance of the service and walked around the buildings to make sure the environment was clean and safe for people to live in.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted health and social care professionals from the local authority who visited the service and received feedback from one relative over the telephone.

Updated 20 March 2020

About the service

Stanley Grange is a service for adults with learning disabilities and complex needs registered with CQC to provide a combination of accommodation and personal care. The service is linked under the same registration which comprised of bungalows, houses, flats and cottages (some shared, some single occupancy). The service had a nursing unit which was registered to provide accommodation and nursing care to no more than six people and also registered to provide accommodation and person care to no more than 30 people who required residential care. The service is also registered to provide personal care to people in a supported living setting. There were 27 people using the residential service, eight people using the supported living service and six receiving nursing care at the time of our inspection.

Whilst the campus style model of service delivery offered to people at this setting does not meet current best practice and not consistent with the principles of Registering the Right Support, there was a person-centred approach to care delivery and people achieved good outcomes. A significant effort had been put to reduce the impact of the historical care model. This was reflected by the ongoing alterations to the structure of the service, accommodation and the clear positive outcomes resulting from individualised person-centred care.

The principles and values that underpin Registering the Right Support, research and other best practice guidance outline that people who use services must be supported to live as ordinary life as possible which includes being an active participant in their local community and living as full a life as possible to achieve the best possible outcomes. How the provider can modernise the model of care will be discussed following this inspection.

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

People were supported by staff who were incredibly kind and caring and who maintained their dignity and privacy and treated them with respect. People were fully involved in the service and had opportunities to give feedback. People's needs, and wishes were fully met by staff that knew them well and were passionate about people’s independence. People were respected and valued as individuals and empowered as partners in their care in an exceptional service. Typical of people’s comments were, “I can truly say without the help and people believing in me I would not have come this far, you’ve got to give people a chance. I’m proof with the right support staff team, training and understanding the person and seeing them as a person they can succeed and have a good life doing the things they choose.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, and in their best interests. There was a proactive effort to promote community involvement and people’s liberties. The policies and systems in the service supported this practice. Staff training was developed and delivered around people’s needs. The provider recognised continuing development of skills, competence and knowledge was integral to ensuring high-quality care and support. People received a balanced diet which met their individual needs and took into consideration their preferences. Staff sought to improve people’s care, treatment and support by identifying good practice.

People were assisted to learn to be involved in managing their medicines and received their medicines in a safe way. Staff were committed to enabling people to do as much for themselves as possible. Staff knew how to keep people safe and the service learned from accidents and incidents and used this learning to improve the service. Staff were recruited in a safe way and there were enough staff to meet the needs of each person.

People received personalised care and support specific to their needs and preferences. This had been effective in supporting people to achieve their goals and aspirations and encouraged more freedom for people. People’s communication needs were assessed and staff used various tools to assist people with communication needs. Improvements had been made to complaints procedures in the service. However, there were mixed views regarding how complaints were dealt with. The registered manager and the provider needed to review and further improve how they received and shared outcomes of complaints with people and their relatives.

The service was well-led. The registered manager and the management team provided a positive model for all the staff. Feedback about the registered manager was positive and staff felt well supported. Staff were motivated and proud of the service, and morale was high. There had been several improvements made since the last inspection. There was a positive and warm atmosphere throughout the service during our inspection.

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

Rating at last inspection

The last rating for this service was good (published 19 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.