Archived: Romford Grange Care Home

Updated 21 July 2018

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 home, and to provide a rating for the home under the Care Act 2014.

The inspection was carried out on 3 and 4 July 2018 and was unannounced. The inspection was undertaken by one inspector 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.

Before the inspection we reviewed relevant information that we had about the provider including any notifications. A notification is information about important events which the provider is required to tell us about by law. We also received a provider information return (PIR) from the home. A PIR is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make. We also made contact with health and social professionals for feedback.

During the inspection we spoke with the regional manager, a quality officer, the registered manager, the deputy manager, maintenance staff member, two nurses and four care staff. We also spoke to 10 people and six relatives.

We reviewed documents and records that related to people’s care and the management of the home. We reviewed four people’s care plans, which included risk assessments and five staff files. We looked at other documents held at the home such as medicine records, training records and quality assurance records.

Updated 21 July 2018

We undertook an unannounced inspection of Romford Grange Care Home on 3 and 4 July 2018. Romford Grange Care Home 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. Romford Grange Care Home is a care home for up to 41 older adults. This included people with dementia. At this inspection there were 36 people living in the home.

At our last inspection on 9 June 2017, the home was rated ‘Requires Improvement’. The home was in breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as we found that the premises were not being maintained. We also found that room temperatures where medicines were stored exceeded recommended levels, activities did not meet people’s needs and robust audit process were not in place to identify shortfalls. At this inspection we found improvements had been made in these areas and the home has been rated ‘Good’.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the home is run.

Risks had been identified and assessed, which provided information to staff on how to mitigate risks to keep people safe. Staff had been trained in safeguarding adults and knew how to keep people safe.

Medicines were managed safely. We found that people’s Medicine Administration Records (MAR) had been completed accurately. Medicines was being administered as instructed on people’s MAR, or in accordance with the provider’s policy. Medicines were stored securely and within accepted temperature levels.

Incident records were reviewed and these showed the provider took appropriate action following incidents that had been recorded. Systems were in place to analyse incidents for patterns and trends to ensure lessons were learnt and incidents were minimised.

Systems were in place to reduce the risk and spread of infection. Staff had access to personal protective equipment and used this when needed.

There were sufficient staffing levels to support people. Dependency assessments were carried out to calculate the number of staff needed contingent to people’s needs. Premises safety checks had been carried out to ensure the premises was safe.

Staff had the knowledge, training and skills to care for people effectively. Staff felt supported to carry out their roles. However, supervisions of staff had not been completed regularly, to ensure staff felt supported at all times. We made a recommendation in this area.

People had choices during meal times and were supported with meals when required. People and relatives told us people enjoyed the food. People’s weights were regularly monitored and referrals made to health professionals if there were concerns with people’s weight. People had access to healthcare services.

Some people who lived at the home were deprived of their liberty under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty applications had been made and granted to restrict people’s lawfully. Staff were aware of the principles of the MCA and assessments had been carried out to determine people’s ability to make decisions in certain areas.

People and relatives told us that staff were friendly and caring. Our observations confirmed this. People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights. People had been involved with making decisions about their care.

People received care that was shaped around their individual needs, interests and preferences. Care plans were person centred and staff knew how to provide personalised care to people. People and relatives were aware of how to make complaints if they wanted to and staff knew how to manage complaints.

Regular activities took place in the home. However, there was not a schedule in place for individual activities for people. We made a recommendation in this area.

Staff felt well supported by the management team. People, relatives and health professionals were complimentary about the management of the home. Quality assurance and monitoring systems were in place to make continuous improvements.