Background to this inspection
Updated
1 February 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 two 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
Apley Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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.
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 and professionals who work 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 seven people who used the service and one visiting relative for their feedback about the service. We spoke with five members of staff including the registered manager, two nurses, one care worker, an activities co-ordinator and the cook.
We reviewed a range of records. This included three people’s care records and multiple 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 policies and procedures.
After the inspection
The provider sent further documentation to us in relation to training records and risk assessments.
Updated
1 February 2020
About the service
Apley Grange is a care home providing personal and nursing care to 38 people aged 65 and over at the time of the inspection. The service can support up to 42 people.
The service is spilt into three areas; Hilda House which provides support for people who live relatively independently, Margaret's House which provides nursing care and Cornelia House which specialises in providing care to people living with dementia, some of whom require nursing care.
People’s experience of using this service and what we found
People were safely supported to meet their needs and improve their quality of life. Staff were safely recruited and enough staff were deployed to support people in a patient and caring way.
Staff understood people's needs, risks and how to provide safe support. Medicines were managed and administered safely. Checks of bed safety rails and window opening restrictors had not been documented, health declarations were not recorded for all staff and there were minor examples where risks assessments would benefit from more detailed information. We made a recommendation about documentation in relation to risks and how these were managed.
The registered manager was very responsive to feedback and clearly committed to continually improve the service. They promoted a very person-centred culture. Staff worked together to effectively meet people’s needs and improve their quality of life. Regular audits helped monitor the quality and safety of the service.
People were treated with dignity and respect and their independence was promoted. Staff encouraged people to engage with their relatives and friends. Activities and events were arranged with people’s hobbies and interests in mind. People were supported to access the wider community.
People were well cared for by staff that were trained and supported to carry out their roles. Staff knew people extremely well and were knowledgeable about when to refer to other health professionals for advice and/or support. Communication care plans were in place to support people’s communication preferences.
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’s choices were respected by staff.
People were given opportunities to express their views and make suggestions, these were listened to and respected. The service was responsive to support people’s needs which had a positive impact on all aspects of their well-being.
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 (published 5 August 2016). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
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.