Background to this inspection
Updated
2 April 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
This inspection was carried out by three inspectors 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
Anisha Grange is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as 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. 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 and carried out on 22 and 23 January 2020. We received further information on 5 February 2020 which was used to inform the inspection.
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 who worked 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 took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with nineteen people who used the service and four relatives about their experience of the care provided. We also 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 talk with us.
We spoke with the registered manager, the managing director and four other members of the management team. We spoke with 10 further staff members including care staff, nursing staff and domestic staff. We reviewed a range of records. This included eight people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training records and policies and procedures were also reviewed.
After the inspection
We contacted four health and social care professionals for their feedback on the service. We requested further information from the registered manager and continued to seek clarification from the provider to validate evidence found
Updated
2 April 2020
About the service
Anisha Grange is a nursing home registered to provide accommodation, nursing and personal care for up to 74 older people, some who may have care and support needs associated with dementia. People were accommodated in one of three units (known as communities) over three floors. Valentine, the nursing community, was on the ground floor. People with dementia mainly lived on the first floor in the Primrose community, whilst people who did not have nursing or dementia needs predominantly lived in the Autumn Way community on the second floor. At the time of our visit there were 65 people living at the service.
People’s experience of using this service and what we found
People provided glowing feedback about the service, and staff team. This was summed up by one person who said, “I couldn’t be in a better place with lovelier people.” Without exception, all of the people we spoke with told us they felt safe and happy living at the service. Considerable time and resources had been invested to ensure people enjoyed living at the service and they were provided with lots of opportunities to live full and varied lives. People told us they had so much to do they couldn’t always fit it in and were never bored. A person told us, “There’s no reason to be bored here, there’s so much going on.”
Staff were skilled and competent in their job roles. The training staff received was of a very good quality and staff were encouraged to continuously develop their skills and knowledge. People were supported to have as much choice and control over their lives and were supported in the least restrictive way possible. The policies and systems in the service support this practice.
Feedback from healthcare professionals showed staff had empathy and understanding when supporting people living with dementia to manage their emotions and behaviours. A professional told us, “Care staff present as passionate about understanding the resident as an individual, their history and why they may be behaving in certain ways.”
Best practice guidance had been followed to support people with dementia to have opportunities for meaningful engagement using intergenerational activities. People had access to resources to help them reminisce, which enriched their quality of life, mental wellbeing and self-esteem.
New ways of working had been introduced to help reduce social isolation and loneliness in people identified at risk. A person told us, “‘I’m in bed all day, but I see plenty of people, I don’t feel lonely.” Strong links with the community had been forged which provided people with opportunities to feel like valued members of their community and promote their social inclusion.
An outstanding feature of the service was the open and transparent way complaints were dealt with. The registered manager was extremely responsive to people’s concerns, making every effort to ensure people felt listened to and were happy with the way their complaints were managed.
People’s needs and wishes for their end of life care were explored in a very person centred way and documented in detail to ensure people were supported the way they wanted.
The leadership of the service was exceptional and significant improvements had been made and sustained. People and staff held the registered manager in extreme high regard. They were highly visible and approachable and considered to be extremely kind and caring.
Of note, was the highly positive culture that had continued to grow and develop under the direction of the registered manager. An inclusive and highly caring ethos was evident throughout the organisation which was strongly promoted by the management team and provider and shared by the staff team.
Staff at all levels told us they were proud to work at the service and without exception, all staff we observed and spoke to demonstrated a high degree of passion, enthusiasm and commitment to providing high quality, person-centred care and support.
People and staff were listened to, valued and fully included in how the service was run. Feedback was actively sought and responded to positively, to continuously improve. Staff were recognised and rewarded for their hard work and for going the extra mile. This contributed to the high morale of staff.
The safety and quality of the service was consistently monitored. Regular audits on all aspects of the service were completed and improvements made when needed. Various innovative projects were underway aimed at improving the health and wellbeing of people and staff.
The ways of working seen throughout our inspection accurately mirrored the provider's visions and values as set out in the company charter. The charter was dedicated to ‘developing quality environments and high standards of care to enable people to enjoy life to the full, as individuals, in happy, comfortable, and safe surroundings.'
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 (June 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.