Background to this inspection
Updated
26 July 2019
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
The inspection was carried out by one inspector.
Service and service type
Grimston House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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. The registered manager was on pre-planned annual leave. The deputy manager was present throughout our inspection.
Notice of inspection
This inspection was unannounced. Inspection activity started on 17 June 2019 and ended on 20 June 2019. We visited the service on 17 June 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection on 23 September 2016. This included details about incidents the provider must notify us about, such as abuse or when a person dies. We sought feedback from the local Healthwatch for information about the service. We were notified that they had no feedback about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider completed a Provider Information Return (PIR). We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We contacted healthcare professionals for feedback. We received comments from one person. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During the inspection, we spoke with eight people using the service, four visiting relatives, two healthcare assistants, one senior healthcare assistant the deputy manager. We observed interactions between people and staff in the communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also looked at the environment, including the communal areas, bathrooms and people's bedrooms.
We reviewed a range of records based on the history of the service. This included four people's care records and medicines records. We also looked at three staff files including their recruitment, supervision and training records. We reviewed records relating to the management of the service, quality assurance records and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and surveys they completed to share their views.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We received maintenance and training data we had requested us in a timely manner.
Updated
26 July 2019
About the service:
Grimston House is a care home that provides accommodation and personal care for up to 21 adults in one adapted property. There were 17 people living at the service at the time of the inspection. People using the service were older people with varying needs.
People’s experience of using this service and what we found
People told us they felt safe and received a good service, their comments included, “I am very happy living here, I have recommended the home,” and,” I feel I am looked after very well.”
Managers and the staff understood their responsibility about safeguarding people from abuse, staff had been appropriately trained and knew how to recognise and raise safeguarding concerns. Peoples medicines were managed safely. People said they received their medicines when they needed them. There were policies and procedures in place for the safe administration of medicines, staff followed these policies and had been trained to administer medicines safely.
Staff knew how to keep people safe from risks. Risk assessments were up to date and staff had clear written guidance on what to do to keep risks to a minimum. Any incidents and accidents were recorded and steps were taken to prevent any re-occurrence. Staff understood how to prevent infection and wore protective equipment when necessary.
There were enough staff on duty to meet people’s needs. A robust staff recruitment procedure and relevant checks ensured suitable staff were employed. Staff were trained and received regular supervision and appraisal.
People's needs were assessed before they started using the service. People were supported to express their views and make decisions about their care. People’s care plans provided guidance for staff to ensure care and support was delivered as people wanted it and was responsive to their needs.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff treated people with dignity and respect. Staff helped to maintain people's independence by encouraging them to care for themselves where possible. People were supported to do things they wanted to do.
People said they enjoyed the food and could have snacks and drinks when they wanted to. Staff supported people to maintain a balanced diet and monitor their nutritional health.
When people were unwell or needed extra support, they were referred to health care professionals and other external agencies. People’s end of life wishes were recorded and people were supported at the end of their lives to be comfortable and pain free.
People knew how to complain or make comments and suggestions. People were asked their view about the service at meetings and by completing surveys, suggestions had been acted upon.
The service continued to be well led. Effective quality audits continued to be in place and continuous improvement and learning were embedded in the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Good – (published on 26 October 2016).
Why we inspected
This was a planned inspection based on the previous rating. The service remained 'Good' overall.
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.