31 August 2016
During a routine inspection
We undertook this unannounced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan, and confirm that the service now met legal requirements. We found improvements had been made in the required areas.
The overall rating for Gracewell of Hove has been revised to good. We will review the overall rating of good at the next comprehensive inspection, where we will look at all aspects of the service and to ensure the improvements have been sustained.
Gracewell of Hove is registered to provide accommodation and care, including nursing care for up to 35 older people, with a range of medical and age related and chronic conditions, including arthritis, frailty, mobility issues and dementia. The service is located in Hove, East Sussex in a residential area. There were 28 people living at the service on the day of our inspections. Gracewell of Hove belongs to a large corporate organisation called Gracewell Healthcare. Gracewell Healthcare provides residential and nursing care across England.
There was a manager in post, who had applied to become the registered manager. However at the time of our inspection, they were not registered with the CQC. 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.
People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “I definitely feel safe, there’s always someone around you can call if you need to”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.
Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.
People were being supported to make decisions in their best interests. The manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).
Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including caring for people at the end of their life and oral health training. Staff had received both one-to-one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place. One member of staff told us, “I’ve been speaking to my team leader about doing anNVQ 3 (National Vocational Qualification Level 3)”.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. One person told us, “Meals are pretty good and hot”. Special dietary requirements were met, and people’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.
People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. One person told us, “I enjoy the company of the staff. They don’t have to do much for me, but they are very caring. I see them paying a lot of attention to people who are stuck in their rooms”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible.
People chose how to spend their day and they took part in activities in the service and the community. People told us they enjoyed the activities, which included singing, exercises, films, arts and crafts and themed events, such as reminiscence sessions, pamper days and pub nights. One person told us, “I’ve had good conversations with [the activities co-ordinator]. They try to put you in touch with others with similar interests. If I went home I’d be lonely. Here there’s a sort of independence, but people are in and out all the time and there’s so much activity. I’ve been to a number of exercise groups, and like to go and listen to the singers who come. I could go out on trips in the minibus, but I go out enough”. People were also encouraged to stay in touch with their families and receive visitors.
People were encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns. The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.