Background to this inspection
Updated
16 April 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
The Inspection was carried out by one Inspector.
Service and service type
Sherbourne 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.
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. 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 looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. We reviewed information that had been sent to us by commissioners from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service, four relatives and two professionals about their experience of the care provided. We spoke with eight members of staff including the registered manager, deputy manager, senior care worker, four care workers, the cook and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spent time speaking with and observing people over the course of the day to understand their experience of the care they received.
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 were reviewed.
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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visited the service.
Updated
16 April 2020
About the service
Sherbourne Grange is a residential care home providing accommodation and personal care to 14 people who have a learning disability, autistic spectrum disorder or physical disabilities at the time of the inspection.
The home is two large specifically adapted buildings merged into one bigger than most domestic style properties. It was registered for the support of up to 16 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, industrial bins or anything else outside to indicate it was a care home.
The service applied the principles and values of Registering the Right Support (RRS) and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People’s experience of using this service and what we found
The provider had safeguarding systems and processes in place to keep people safe. Staff knew the risks to people and followed the assessments to ensure they met people’s needs. The number of experienced and knowledgeable staff was sufficient to meet people's needs. Staff followed the infection control procedures the provider had in place. Incidents and accidents were monitored, and lessons were learned when things went wrong.
People’s needs and choices were assessed, and care was reviewed regularly. Care plans identified the involvement of people in the care they received. The consistent staff team received regular refresher training. People were supported to eat healthily and maintain fluids. People were supported to access healthcare services and activities to promote their wellbeing. People were also supported to access healthcare services as they needed.
Care was person-centred with people's privacy, dignity and equality maintained. People were involved in their care and supported to express their views. The staff made every effort to get to know people and understand what was important to them.
Care was personalised, and people were supported to effectively communicate their needs and preferences. The provider had a complaints procedure in place to manage and respond to any complaints they may receive. People were supported to maintain relationships with their families and to engage in activities that interested them.
Quality assurance systems were robust with spot and competency checks completed regularly. The registered manager understood their legal responsibilities in regard to safeguarding and notifications. The provider worked with other professionals such as district nurses and GP's to ensure care needs were met.
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.
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 12 September 2017).
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.