24 and 25 November 2015
During a routine inspection
We undertook this unannounced inspection on the 24 and 25 November 2015. At the last inspection on 15 and 16 December 2014 we found the registered provider was non-compliant in one of the areas we assessed. We issued a compliance action for concerns about the management of medicines. We rated four of the five key questions we ask as ‘Requires Improvement’ and the fifth as ‘Good.’ During this follow up comprehensive inspection we found improvements had been made in all areas with all key questions rated as ‘Good.’
Grimsby Grange is a purpose built care home situated in Grimsby close to local amenities. The service is registered to provide accommodation and personal care for up to 47 older people some of whom may be living with dementia. There are three floors; with an enhanced dementia unit on the ground floor.
There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found improvements had been made to the management of medicines in the service. A new electronic medication system had been introduced three weeks before our inspection. People received their medicines as prescribed and they were held securely.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep them safe. At the time of the inspection there were six DoLS authorisations in place and the service was waiting for assessments and approval of the remaining applications they had submitted.
Staff supported people to make their own decisions and choices where possible about the care they received. When people were unable to make their own decisions staff followed the correct procedures and involved relatives and other professionals when important decisions about care had to be made.
We found the service had a relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. We observed staff demonstrated good distraction techniques when managing people who may need additional support to manage their behaviours. They had developed positive relationships with people and their families. We saw people were encouraged to participate in activities and to maintain their independence where possible.
We found people’s health and nutritional needs were met and saw professional advice and treatment from community services was accessed when required. We found people received support in a person-centred way with care plans describing preferences for care and staff following this guidance.
Staff were recruited, trained and supported to meet people’s needs appropriately. We found there were enough staff on each shift to meet people’s needs. Staff told us they felt more supported, they could raise any concerns with the registered manager and felt that they were listened to.
Relatives told us they were aware of the complaints procedure and said issues that they raised were dealt with more efficiently.
There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager and the operations manager. The reports included any actions required and these were checked each month to determine progress. Improvements had been made with the laundry service, but some relatives felt more could be made. The registered manager was looking into this.
Areas of the home had been refurbished and redecorated but there had been some delays with some flooring renewal which was addressed during the inspection. The registered manager intends to expand the environmental audit processes to ensure any further renewals are carried out more expediently.