Pexton Grange is a nursing home that provides care for up to 57 people. It is a purpose built care service. At the time of our inspection 51 people were living at the service. Thirty three of those people were using the intermediate care service provided on behalf of the NHS. Those people have experienced a period of ill health or have been in hospital and are unable to manage at home. They therefore require rehabilitation and support for a short period of time to help them regain their independence. Therapy support for those people was provided at the service by the NHS Sheffield Teaching Hospitals, Community Services. This inspection took place on 17 October 2017 and was unannounced. This meant the staff and registered provider did not know we would be visiting.
There was a registered manager, but they were no longer managing the service. We were informed they were working for the registered provider in another role. The registered provider had appointed a new manager, the former deputy manager, to manage the service. The manager told us they had been managing the service since September 2017, and they had applied to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People we spoke with told us they felt ‘safe’ and did not express any worries or concerns.
Relatives we spoke with felt their family member was in a safe place and did not have any concerns about their family member’s safety.
We found people’s care plans and risk assessments were reviewed regularly and in response to any change in needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.
All the relatives that we spoke with made positive comments about the care their family member had received and about the staff working at the service.
A programme of activities was in place so people were provided with a range of leisure opportunities.
Our discussions with staff showed that a few staff would benefit from further safeguarding training to develop a greater understanding of their role and responsibilities. There were satisfactory arrangements in place for people who had monies managed by the service.
Accident and untoward records did not always show details of the outcome of the investigation and/or a rationale for the resulting action. Although we did not find this had negatively impacted on people who used the service, we saw there was a risk that reportable incidents may not be shared appropriately with the CQC and/or the local safeguarding authority.
Staffing levels were sufficient to meet people’s needs. During the inspection staff responded to people’s calls for assistance in a timely manner.
We saw the registered provider’s recruitment policy needed reviewing to ensure there was clear guidance in place on what information needed to be obtained about candidates before they were offered employment. This was because we found some shortfalls in the staff recruitment records we viewed.
We recommend the registered provider review their recruitment policy and all staff recruitment files are checked to ensure that all the information identified in Schedule 3 has been obtained, and available to demonstrate fit and proper persons have been employed.
We saw that some staff had not been provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.
We saw staff were respectful and treated people in a caring and supportive way.
The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.
We did not find any concerns about the cleanliness of the service. This was supported by people and relatives we spoke with.
People and relatives we spoke with felt if they had any concerns or complaints they would be listened to.
People and relatives we spoke with made positive comments about the way the service was managed.
There were planned and regular checks completed by senior members of staff, and the registered provider, to assess and improve the quality of the service provided. Our findings during the inspection showed some of these checks were ineffective in practice. For example, checks that staff had completed their training.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.