Grizedale

Updated 6 January 2023

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.

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

An inspector carried out the inspection. An Expert by Experience made telephone calls to relatives of people who used the service. 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

Grizedale is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Grizedale is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was conducted through a mixture of unannounced and announced visits.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local commissioners and professionals who worked 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 6 people who used the service about their experience of the care provided and contacted 6 relatives.

We spoke with the registered manager, deputy manager and a care staff member. We also received verbal and written feedback from the whole staff team and from visiting professionals.

We reviewed a range of records, which included two people’s care records, staff files and a variety of records relating to the management of the service, including policies and procedures.

Updated 6 January 2023

About the service

Grizedale is a care home which provides residential care for up to 7 people. People who have a learning disability and may at times have mental health needs are supported at Grizedale. At the time of our inspection there were 7 people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

The registered manager operated an ethos of always striving for excellence and staff found this greatly motivated them. People and relatives said staff excelled at their jobs and always went above and beyond in delivering care. This had led to people having exceptional experiences. People had become integral to the community and were welcomed to local community events. 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.

The person-centred culture was evident throughout all aspects of the service. Support plans were totally individualised and representative of the person. With appropriate permissions the plans included photographs of exactly how to provide support for people and videos about their life history. Staff consistently looked to make positive impacts on each person's life.

People were supported safely with medicines. The deputy manager went beyond and above ensuring medicines were given in line with best practice. They had arranged for the pharmacist to show staff and people what to do in relation to crushed tablets, which was translated into written and pictorial support plans. People found seeing what was happening to their medicine very helpful and reduced any anxiety they might have around taking them.

Staff followed Infection prevention and control good practice guidance. A staff member had become the infection control champion, so made sure staff followed the latest guidance. Their diligent, tireless promotion of best practice has led to no one contracting COVID19 or other respiratory diseases throughout the pandemic.

Right Care

Staff promoted equality and diversity in their support for people. The registered manager continually looked at how to enhance the service. They involved staff and people in thinking about creative ways to ensure the service delivered optimum care and support. The culture within the service had assisted people to form great friendships with each other and people in the wider community. Staff acted as advocates and put together compelling cases to ensure everyone received equitable and effective care. The strong advocacy principles had led to significant improvements for people’s quality of life.

The provider had enough appropriately skilled staff to meet people’s needs and keep them safe. Where people had support, this was flexible, generally available and to the level needed. Staff had developed a comprehensive activities programme, which was designed to assist people to explore their hidden talents and aspirations. Multiple examples were provided around how the service had enriched people’s quality of life. Staff discussed how they treated each day as a new one for finding opportunities for people to have rich and varied experiences. People discussed with joy how their lives were wonderful and meaningful.

Right culture

The registered manager was open to new ways of working and ongoing improvements were introduced to promote independence and inclusivity. The registered manager took an active role in supporting staff with career development and increased staff awareness around the positive impact they could have on people's lives. This in turn had led to staff continually striving to provide an outstanding service and very low turnover. Staff morale was very high, and the registered manager recognised having a happy workforce led to continuity of care and people always being supported by those who really know them.

The registered manager fostered a culture of belonging and encouraged collaboration. Staff placed people’s wishes, needs and rights at the heart of everything they did. The provider had been so impressed with the innovative creation of video support plans they were now rolling this practice out across the other homes they operate. Staff sought advice and feedback from everyone involved in people's care. The registered manager acted as an advocate and readily challenged when people were not receiving equitable care.

Staff were passionate about providing good care outcomes and took ownership for their practice. People found the service provided a high standard of care and the quality of staff working with them was exemplary. Staff found the registered manager introduced exceptionally innovative, caring and empathetic ways to support people to get the best quality of life possible. The team had won a range of awards as had the people who used the service.

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

Rating at last inspection

The last rating for this service was good with the caring domain rated as outstanding (published 13 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.