Background to this inspection
Updated
1 May 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 one inspector.
Service and service type
Grange View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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 who had been appointed since we last inspected. 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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all of this information to plan our inspection.
During the inspection-
We looked around the home, reviewed records relevant to the running and quality monitoring of the service, the recruitment records for all new staff employed since the last inspection and policies and procedures. We looked at training and supervision records. We looked at three care records and records of medication administration, medicines storage and management.
We spoke briefly with four people living at Grange View and two people offered to show us their bedrooms and expressed they were very happy living at Grange View. We observed people's daily routines and staff interaction. We spoke with three staff members on duty, including the registered and deputy managers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records. We also contacted three external health and social care professionals and two relatives for their views on the service provided.
Updated
1 May 2020
About the service
Grange View is a residential care home providing accommodation and personal care for up to seven younger adults with lifelong complex needs associated with learning disabilities and autism. At the time of the inspection the home was fully occupied. The service had been developed and designed taking into account best practice guidance and the principles and values underpinning Registering the Right Support. Staff were highly skilled in supporting people to lead as independently as possible and meaningful lives of their choosing. The service was focused on providing a smooth and meaningful transition for people moving on from children’s services into adult life.
People’s experience of using this service and what we found
The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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; the policies and systems in the service supported this practice. Since the last inspection people's life opportunities and quality of life had greatly improved. This was because of the service's commitment in ensuring each person had an individualised support plan designed with support from the provider’s in-house healthcare professionals.
There were enough numbers of suitably qualified staff to meet people’s individual needs. Risks to people’s well being and safety had been identified and well managed. Where safeguarding concerns or incidents had occurred, these had been reported to the appropriate local authorities. Medicines were managed safely, and staff gave people the right level of support they needed to take their medicines. When employing people, the provider had completed checks to ensure they were suitable to work with vulnerable people.
Staff training and development was on going and they had received specific training to safely support and care for people with complex needs. Staff were regularly supported by the registered manager and their deputy through staff meetings, supervision and appraisals. Where relevant people were fully involved in meal preparations and their nutritional needs were met. People and their families had been fully involved in consenting to the care and support provided. The in-house health professionals, who supported the staff team, worked closely with a variety of external agencies and other health professionals to provide exceptionally detailed support plans to meet people’s physical and emotional needs and to achieve their goals.
Staff respected and valued people as individuals and treated them with respect and made sure their privacy and dignity were maintained. People were fully supported to be in control of their lives and be as independent as possible. People had developed trusting and positive relationships with the staff team. Staff were skilled in the communication needs of people and the in-house professionals used nationally recognised assessment tools to establish people’s abilities, needs and choices. People were empowered in setting their own goals and aspirations. This resulted in people achieving positive and life changing outcomes, including one person planning their move from the home to live in the community.
People were supported to have a very active part in the local community and were encouraged to make friendships outside of the home. With enabling support from staff some people were engaged in paid employment, work placements, college courses, volunteer work and socialised in the local community. Staff were focused on people having as many opportunities as possible for them to gain new skills and become more independent. People knew how they could raise concerns about the service provided.
The provider had employed a new registered manager since we last inspected and jointly they regularly monitored the quality and safety of the service. Governance and quality assurance were well-embedded within the service. The leadership of the service promoted a positive, open culture. The registered manager and staff team worked closely with other agencies and healthcare professionals to make sure people had excellent care. Feedback recently gathered by the provider highlighted that 100% of external professionals and relatives, when asked felt the service was well-led.
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 13 September 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.