Archived: Minster Grange Care Home

Updated 3 January 2024

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 3 inspectors and a regulatory co-ordinator.

Service and service type

Minster Grange Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Minster Grange Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 17 November 2023 and ended on 8 December 2023. We visited the location’s service on 17 and 21 November 2023.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and 3 relatives about their experience of the care provided. We spoke with 18 members of staff including the manager, the deputy manager, the operations director, nurses, senior care workers, care workers, lifestyle co-ordinators, kitchen staff and agency staff. We also spoke with the nominated individual who is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 13 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including training data and quality assurance records were reviewed.

We requested an action plan during the inspection in respect of our inspection findings.

Updated 3 January 2024

About the service

Minster Grange Care Home is a residential care home providing personal and nursing care for up to 62 people. The service provides support to people with physical disabilities and older people, some of whom are living with dementia. At the time of our inspection there were 40 people using the service. People are supported across 3 floors. Each floor has its own communal areas.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Risks to people were not appropriately assessed, monitored, and managed. People’s care plans did not always reflect their current needs. Lessons had not been learnt following previous CQC inspections. There were not enough staff to provide safe and person-centred care. Staffing levels were increased for the second day of our inspection. Medicines were not always managed safely.

The mealtime experience for people was poor. People had to wait long periods of time for meals and there was limited choice. Due to staffing levels, people did not always receive personal care in a timely manner.

People were generally supported to have maximum choice and control of their lives although staffing levels impacted this. Staff tried to support people in the least restrictive way possible and in their best interests, although again staffing levels impacted these practices.

The provider failed to make and sustain necessary improvements. There was a lack of clear and positive leadership. The service had a poor regulatory history and failed to improve despite professional input and assurances from the senior management team. There was no registered manager. Staff spoke of a poor culture and some staff felt they were not treated equitably.

The building was well maintained, and regular health and safety checks were completed. The service was clean and tidy. Staff were kind and caring, and worked hard to support people in line with their choices and preferences. However, this was restricted by staffing levels. Staff had received appropriate training for their roles and were knowledgeable about people’s needs. The operations director and nominated individual were responsive to our feedback.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 June 2023) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the quality of care delivered. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe, effective, and well-led.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Minster Grange Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to staffing, dignity and respect, safe care and treatment, and good governance.

Whilst enforcement action was proposed and being processed, the provider submitted a voluntary application to de-register this location and therefore enforcement action did not proceed.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. The provider has submitted a voluntary application to de-register this location.