Grange Court Residential Home

Updated 30 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 31 October 2017 and was unannounced.

The inspection team consisted of two Adult Social Care inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this occasion, the expert-by-experience had experience of services for older people and dementia care.

We used a number of different methods to gather and review information about the service. We reviewed notifications received from the service and information from the local authority commissioning and adult protection teams. We usually request the provider submits a Provider Information Return (PIR) prior to inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We had not requested a PIR on this occasion.

During the inspection we spent time observing care and support, spoke with nine people who were living at the service and three relatives. We also spoke with the operations manager, the registered manager, one senior care staff member and four care staff, the cook, the activities co-ordinator and three visiting health care professionals. We looked at elements of five people's care records, medicines administration records (MARs), two staff records and other records which related to the management of the service including training records, quality assurance processes, policies and procedures.

Updated 30 November 2017

Our inspection of Grange Court Residential Home took place on 31 October 2017 and was unannounced. This was the first inspection since the service had re-registered under a new legal entity.

Grange Court is registered to provide accommodation and personal care for up to 30 people. The home is situated in a residential area of Baildon, a few miles from Shipley town centre. There is a large lounge area, a conservatory, two dining rooms, and bedrooms situated on the ground and first floor as well as enclosed garden areas. At the time of our inspection there were 26 people living at the service.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission 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.

Staff had received training on how to keep people safe and understood how to recognise and act on signs of abuse. Appropriate safeguarding referrals had been made and incidents/accidents were documented with actions taken. People had assessments in place to mitigate risk which were up to date. Some people's personal emergency evacuation plans needed to reflect current mobility needs.

Medicines were mostly managed safely and people received their medicines when required. Greater care needed to be taken to correctly record medicines stock amounts such as Paracetamol. The medicines trolley was left unattended and unlocked on one occasion during the administration of medicines in the dining room when a number of people were present.

Staff were recruited safely and sufficient staff were deployed to keep people safe although some concerns were expressed by staff, people and relatives about staffing levels at night time. Training was in place to ensure staff were kept updated and people told us staff knew what they were doing. Staff were kind and gentle with people and we saw good relationships had been developed. People told us they felt safe living at the home and looked comfortable in staff presence.

The service was operating within the legal requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). People's consent was requested for care and support and documented decisions made in people's best interests.

Care records were person centred and specific with good attention to detail. Reviews of people's care records needed to evidence involvement with people and/or relatives. People's end of life wishes were recorded and advanced care planning in place as required.

The service used assistive technology to assist with people's healthcare needs as well as allow people to communicate with relatives who lived abroad.

Activities reflected the wishes and interests of the people living at the home. People's choices were respected and independence promoted wherever possible. Relatives were welcomed warmly and staff clearly knew people and their relatives well.

Any complaints were treated seriously and investigated with outcomes documented. A number of compliments had been received by the service.

Relatives and healthcare professionals told us communication from the service was good.

People received a well-balanced and nutritional diet and any concerns with people's weight or food/fluid intake was referred to the GP. Food and fluid charts were completed and nutritional supplements in place where required.

The culture of the service was open and transparent with staff and the management team passionate about making a difference to the lives of people living at the service. The registered manager was a visible presence within the home and led by example.

A range of quality audits were in place to monitor and drive improvements within the service. People's voices were listened to through meetings and surveys, with actions taken as a result.

All the people we spoke with would recommend Grange Court as a place to live.