Archived: Grange House

We found the following examples of good practice.

People were supported to have family and friends visit them using the ‘safe time pod’. This is an area built onto the visiting room which had a separate entrance and was separated from the visiting room by a window and Perspex screen. There were speakers on either side in order for people to communicate whilst being able to see their relative. The safe time pod was then cleaned by a member of the housekeeping staff between each use.

There were clear procedures in place for visiting professionals. At the entrance to the home, there was a personal protective equipment (PPE) station and a sign about infection control which had been written by people living at the home. Visiting professionals had their temperatures taken by staff and were asked whether they had been in any contact with anyone with either symptoms of or confirmed COVID-19.

Staff at the home were wearing gloves, masks and aprons at all times. The registered manager told us this was because people living at the service were likely to come up to staff and be in close contact with staff to interact with them. Staff changed their PPE after each close interaction with someone living at the home.

All staff had risk assessments in place to identify any factors that may place them at increased risk from COVID-19. This included consideration for staff from a black and minority ethnic (BAME) background. These risk assessments had informed the home’s plans for staffing different areas of the home if an outbreak should occur. Staff were already aware of where they would be working within the identified zones of the home should there be an outbreak.

The registered manager had worked hard during the pandemic to bring the staff team together to provide individualised care to people living at the service. Activities at the home were based on people’s individual likes and hobbies.

Further information is in the detailed findings below.

Grange House is a residential care home providing personal care to 16 older people, many of whom were living with dementia or other mental health disorders. The service can support up to 17 people. Grange House is a converted property situated in a residential area of Eastbourne. The home accommodates people in one adapted building over two floors.

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

People were supported by staff that demonstrated a compassionate and caring approach to their work. People and their relatives told us that they liked living at Grange House and that they felt safe living there. One person said, “It's nice. It's a pleasant atmosphere and homely.”

The needs of people living with dementia were well supported. Their family members told us that they felt relieved and comforted that they were care for by skilled and caring staff. One relative said, “She still has moments of clarity. They have managed her so well. They told me not to worry. They managed the confusion, I felt so reassured.”

Risks to people’s physical and mental wellbeing had been assessed and staff ensured that these risks were reduced as much as possible. People were supported by enough skilled and trained staff to meet their needs. People’s independence was promoted by staff. People were treated with respect and dignity and supported to make decisions about their care.

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.

People were supported by a management team that looked to ensure they received good person-centred care. The quality of care people received was audited and monitored by staff using effective quality assurance systems.

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. (2 August 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.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.

At our previous inspection on 21 and 22 April 2015, the service did not have a registered manager in post as required by law. We also found that the registered provider did not use quality monitoring systems effectively to make the necessary improvements in relation to concerns raised about health and safety, complaints and the results of satisfaction surveys.

At this inspection, we found that the service used the quality assurance systems in place effectively to identify shortfalls and to make improvements to the standard of care provided. Action plans showed the provider addressed the shortfalls identified during regular audits in line with their designated timeframes.

People received safe care that protected them from the risk of abuse. Staff understood their responsibility to identify and report any concerns about people’s health and well-being. Staff attended training in safeguarding adults and knew the procedures to follow to keep people safe.

People received appropriate support to mitigate identified risks to their health and safety. Risk management strategies remained effective in ensuring staff protected people from the risk of avoidable harm.

Appropriate recruitment practices ensured that only staff vetted as suitable to provide care worked at the service. Sufficient numbers of staff supported people safely and met their needs.

Staff received the support, training, supervisions and appraisals required to enable them to undertake their roles effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had their care delivered in line with the requirements of the Mental Capacity Act 2005 and the restrictions placed on their freedoms under the Deprivation of Liberty Safeguards.

People told us staff treated them with kindness and compassion. Staff knew people well and had developed good working relationships with them.

People had their nutritional and hydration needs monitored and met. Staff supported people to eat and drink and to maintain a healthy balanced diet. People had access to healthcare services when needed to maintain their health and well-being in a timely manner.

People took part in planning and making decisions about how they wanted their care delivered. Assessments of people’s needs enabled staff to design and provide care suitable to each person and their individual preferences.

The registered manager sought people’s views about the service and acted on the feedback received to improve the quality of care. People using the service and their relatives knew how to raise any concerns and make a complaint if they were unhappy about the service. A complaints procedure was accessible to people in a format they understood.

People, who were able to, told us they were happy living at the home. One person told us, 'I am happy here with my friends.' Another person told us, 'I am looked after, the food is too good though.'

We spoke with two visitors to the home. They all told us they were happy with the care provided to their relative. One visitor told us, 'The staff are so caring, I visit every day and can't fault them, wonderful people.' Another visitor said, 'A very happy and clean home.' All visitors we spoke with told us they were kept informed about their relative. This included changes in health or new care needs. The care records were reflective of the care delivery given to people.

We looked at medication records and saw that the home had systems and processes in place that ensured people were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines.

We examined four staff files and found that the provider used effective recruitment and selection processes to ensure the care and safety of people living at the home. All staff were subject to appropriate checks before they began working at the home.

There was a complaints policy in place and there were clear processes to deal with complaints correctly.

Staff told us they had regular training and supervision. We saw records that showed that people were involved in decisions about their care and that people were treated with dignity and respect. We looked at training records that showed that staff had received career development to help them perform their roles safely and well. We found that the home was clean and comfortable and the provider had effective quality assurance systems in place to monitor their service delivery.