Grassington House

Updated 12 September 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 was planned to check 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 site visit took place on 7 August 2018 and was unannounced. The inspection continued on the 8 August 2018 and was announced. The inspection was carried out by one inspector and an inspection manager on both days.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.

We had not requested a Provider Information Return (PIR) to be completed . This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We gathered this feedback from the registered manager during the inspection.

We spoke with three people who used the service and four relatives. We spoke with three health and social care professionals, five staff and one visitor to the home.

We spoke with the registered manager and the deputy manager. We reviewed four people’s care files, four medicine administration records, policies, risk assessments, health and safety records, consent to care and quality audits. We looked at four staff files, the recruitment process, complaints, training and supervision records.

We walked around the building and observed care practice and interactions between staff and people who live there. We used the Short Observational Framework for Inspection (SOFI) at meal times. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We asked the registered manager to send us information after the visit. This included policies and training information. They agreed to submit this by Friday 10 August 2018 and did so via email.

Updated 12 September 2018

Grassington House is a residential care home for 13 older people living with dementia, mobility difficulties and sensory impairment. There are three floors with the first floor having access via stairs or a lift, access to the third floor is by stairs or stair lift. There is a smaller dining room, a television lounge and a large conservatory lounge leading out onto the gardens. There is level access to the gardens and various seating areas. There were 12 people living at the home at time of inspection.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and the who to report this to if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults.

When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

The service was responsive when things went wrong, were open and reviewed practices and produced action plans to aid learning.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with routine audits to ensure safety with medicines.

People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with professionals such as doctors, occupational therapists and social workers.

People had their eating and drinking needs understood and were being met. People were happy with the quality, variety and quantity of the food. People living in the home were involved in menu planning, shopping for food and their nutritional needs and preferences had been assessed.

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. A person told us “I just let the staff know I am going out and I go out whenever I want”.

The registered manager actively sought to work in partnership with other organisations to improve and nurture positive outcomes for people using the service.

Care and support was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. Staff felt supported and confident in their work.

People, their relatives and professionals described the staff as caring, kind, affectionate and warm. People were able to express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected. A relative said “The reason we chose Grassington House is because it felt like a family, not a just a home”.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories were detailed and people important to them had been consulted.

The home had an effective complaints process and people were aware of it and knew how to make a complaint. People and their relatives felt they would be listened to and actions taken if they raised concerns. The service actively encouraged feedback from people.

People’s end of life needs were assessed and very detailed these included their individual spiritual and cultural wishes. The records showed that people and their relatives had been involved in these plans.

Group and individual activities were provided. People were consulted about what they liked to do with their day. Many people went out throughout the day and some liked to be involved with task around the home. A person told us, “I help around the home, it makes me feel very much better”.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone. A relative told us “They are open with their conversations, you know where you stand”.

Leadership was visible within the home and promoted inclusion. Staff spoke positively about the management team and felt supported. One staff member said, “I really feel I want to do the best for them [the registered manager]” another said, “I feel included”.

There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were carried out and those responsible kept things up to date.

The service understood their legal responsibilities for reporting and sharing information with other services. The registered manager told us, “I have created an open culture within the home”.