About the serviceGrizedale 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.