Woolton Grange Nursing Home

Updated 18 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is 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 took place on 31 October and 7,14 November 2018, the first day of the inspection was unannounced. The inspection was completed by an adult social care inspector.

Before our inspection we considered information we held about the service, such as the notification of events about accidents and incidents which the service is required to send to CQC. We had information from the police about the previous manager of the home who had been charged with theft whilst in previous employment at a different home. This manager was no longer working at the home. We also had information from the local authority about concerns over the management of pressure area care at the home. We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with 16 people who lived at the home. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of some people who could not talk with us. We spoke with six people’s relatives.

We spoke with the owner of the home and 10 members of staff, including members of the management and compliance teams, care staff, the catering team and housekeeping staff. We also spoke with five visiting health and social work professionals.

We looked at 5 care plans for people who used the service, four staff personnel files, staff training and development records as well as information about the management and auditing of the service. We observed staff interaction with people who lived at the home throughout our inspection.

Updated 18 December 2018

The inspection of Woolton Grange Care Home took place on 31 October and 7, 14 November 2018; the first day of the inspection was unannounced.

Woolton Grange Care Home 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 home is registered to provide nursing care and accommodation for up to 43 people; in a converted Victorian church building in a residential area of Liverpool. At the time of our inspection 38 people were living at the home.

The registered manager had not been working at the home since May 2018. The deputy manager was acting manager and had applied to become registered with the Care Quality Commission. 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.

At our inspection in July 2017 there were breaches of regulation 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there were not sufficient numbers of staff available to meet people’s needs in a timely manner; and the systems in place to assess and monitor the safety and quality of the service had not always been effective.

At this inspection we saw that there had been improvements in these areas and the home was no longer in breach of these Regulations.

There were enough staff to meet people’s needs in a timely manner. This reflected the feedback from people, their relatives and visiting health and social care professionals. The home now had a much calmer environment.

The systems used to assess and monitor the safety and quality of the service was now more robust. The provider’s compliance team who support home managers had been increased in the previous twelve months from 2 to 6 people. They said this was done to help support the managers of their homes with monitoring and assessing the quality of the service provided. These checks and audits allowed the acting manager and provider to assess and monitor the safety and quality of the service being provided and when necessary make required improvements.

There was a quarterly meeting at the home were accidents, incidents, any safeguarding alerts and feedback from people living at the home, their family members and staff members was reviewed. Themes were looked for and incidents looked into to ensure that appropriate action had taken place.

People told us that they thought the staff at the home were caring. One person said, “The staff are adorable.” Another person described the staff as “very pleasant.” People’s relatives told us that the service provided was caring and they were made to feel very welcome when visiting the home.

People told us they felt safe living at the home. One person told us, “I feel safe. Safe and comfortable.” Staff had received training in safeguarding vulnerable adults, knew of signs that may indicate a person was at risk of abuse and knew how to raise an alert. The home had appropriately managed safeguarding concerns. The building was safe, the home was clean and the administration of people’s medication was safe.

People were asked questions and their opinion was sought before any care and support was provided. At lunchtime we saw that people were asked questions about their preferences and they were listened to and their requests were acted upon. People were treated with dignity and respect in all their interactions with staff.

The service was provided in line with the principles of the Mental Capacity Act. We saw that people’s consent and permission was sought with their day to day support needs; when this wasn’t possible with significant decisions appropriate procedures were followed to protect people’s legal rights.

People had an assessment of their needs before coming to the home. We saw that these were thorough including details on people’s health, life history and their likes and dislikes including seemingly small but important details. Appropriate care plans were in place using these details and any risks that had been identified.

The service was now responsive to people’s health care needs. Improvements had been made in the response from the service to the risk of people developing pressure sores. Appropriate referrals to health and social care professional had been made and the home worked closely with these professionals.

People told us that they enjoyed the food provided at the home. The kitchen was clean and well stocked. It had been awarded five stars by the Food Standards Agency at their last inspection. We spoke with the chef who had records showing people’s special dietary requirements and their likes, dislikes and preferences.

Feedback overall about activities and having things to do at the home was divided. Some people told us that there was lots to do at the home and others that there was very little to do. We saw a range of activities were provided for people, but these may not have always reflected people’s preferences.

Appropriate checks and induction was in place to help ensure that new staff were safe to support vulnerable adults. There was effective training in place and staff told us they had received appropriate support.

People, staff members and visiting health and social care professionals were all positive about the acting manager of the home. One person told us, “They do extremely well. I don’t think it can be improved.” Another person told us, “The manager is lovely.” We found the acting manager to be a good communicator and there was evidence that they had been effective in leading the service.

The home had appropriate policies in place, displayed the rating from the previous inspection and had sent through appropriate notifications to the CQC.