Archived: The Grange (2016) Personal Care

Updated 16 February 2019

Background

The inspection:

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.

Inspection team:

The inspection team consisted of one inspector.

Service and service type

The Grange is a domiciliary care agency. It provides personal care to people living in their own homes. The agency has only commenced providing this service to one person since October 2018.

There was a registered manager. 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.

Notice of inspection:

We gave the service 24 hours' notice of the inspection visit. We needed to be sure that managers would be available to facilitate this inspection. As part of the inspection we visited the service office and also the home of the person in receipt of the regulated activity.

What we did:

We used information the provider sent us in the Provider Information Return. (PIR) This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

We spoke with the person receiving support during our visit. We spoke with a staff member in addition to the registered manager and nominated individual. No questionnaires were received but post inspection we contacted a further two staff, a relative, a care manager and Community Learning disability nurse for feedback.

We reviewed the person’s care and health related records. We looked at operational records such as policies and procedures, records relating to the management of the service, staff training records and recruitment records.

Updated 16 February 2019

What life is like for people using this service:

The service was well run and people received good quality support. However, the regulated activity had only been provided since October 2018 and the provider was still in the process of fully implementing some of the systems and processes needed for a domiciliary agency. Areas of improvement were needed. A system for the routine assessment and quality monitoring of the service was needed. Staff felt listened to and well supported but regular staff meetings were not held. A staff member told us they thought it would be good for staff to have regular meetings, and said one had already been planned since the inspection. A complaints procedure was in place and a relative informed us that they would have no concerns about raising a complaint if they needed. They felt confident this would be handled appropriately. However, an accessible version of the complaints procedure was not available to the person supported. Staff had received training in safeguarding adults and understood their role and responsibility to recognise respond and report suspicions or observations of abuse. However, an accessible version of safeguarding information was not available to inform the person of their rights. These are all areas for improvement.

Staff received training to support people with all aspects of their daily lives. New staff completed a period of induction to give them the basic knowledge and skills needed to support the person safely and in accordance with their preferences. All staff received regular updates to their training and were also provided with specialist training such as positive behaviour support, or end of life care. Staff supported the persons health needs and took advice from health professionals around this. Care staff were aware of the persons dietary needs.

The person using the service told us that they were happy. Their relative told us that most staff showed commitment to doing a good job and providing people with good quality support. A health professional told us staff were kind and caring. Our observations showed that the person was treated with respect and their dignity and their confidentiality upheld. Staff knew the person well and adapted their support to meet the persons changing health needs. Staff supported the person to live the life they wanted encouraged independence and supported the person to develop a busy leisure and social life. A communication passport informed and guided staff how to recognise and understand how they communicated their needs and wishes.

The provider had just introduced a new electronic care planning system called ‘Iplanit’ staff used hand held tablets to make live changes to the persons records, the new system also enabled the person and or their relatives with the persons permission to access their records at any time. Records were kept securely with electronic records password protected.

A health professional felt that the registered manager and other staff had been “really great” in responding to the changing needs of the person supported including implementation of 24-hour staff cover. There had been a turnover of staff but the registered manager tried to ensure that only bank staff or agency staff familiar with the service and the persons needs were used to cover shifts. This provided better continuity of support wherever possible. The person’s medicines were managed well. Staff sought consent to care and treatment in line with the Mental Capacity Act 2005 (MCA). Individual and environmental risks were appropriately assessed and measures implemented to keep the person safe. Staff spoke positively about the support they received from the manager and a relative told us that they were happy with the registered managers leadership of the service.

Rating at last inspection: This is the first inspection. Not previously rated

About the service: The Grange (2016) Personal Care is registered as a domiciliary care agency providing the regulated activity 'personal care' currently to one person who lives in a supported living service in Cranbrook. The service provides accommodation and support to people who live in a shared house and have their own tenancy agreements.

Why we inspected: Scheduled comprehensive inspection.

Follow up: We will ask the provider following this report being published to tell us how they will make changes to ensure they improve the rating of the service to at least Good. We will revisit the service in the future to check if improvements have been made.