Grasmere Avenue

Updated 28 September 2023

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

Grasmere Avenue is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 9 July 2023 and ended on 7 August 2023. The inspection visit took place on 17 July 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

Some people could not use words to communicate verbally and did not comment on the service. We spoke in person with the registered manager, 2 people using the service, 3 relatives, 5 staff, and 2 healthcare professionals to get their experience and views about the care provided. We reviewed a range of records. They included 3 people’s care plans and risk records. We looked at 3 staff files in relation to recruitment, training, and staff supervision. We checked a variety of records relating to the management of the service, including staff rotas, training, and service level audits. We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. This included staffing and training information, and provider quality assurance audits. We received the information which was used as part of our inspection.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 28 September 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

About the service

Grasmere Avenue is a ‘care home’ that provides care and support for up to 6 people. All the people who live at Grasmere Avenue have a learning disability or were autistic people. There were 6 people living there at the time of the inspection.

CQC regulates both the premises and the care provided, and both were looked at during this inspection.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right Care, Right Culture.

Right Support

Staff supported people, to be given maximum choices, control, and independence. Personalised communication strategies were used to support people to understand and make their choices and creative ways found to promote learning and for people to develop their existing and new skills. Staff were focused on people's strengths to enable them to lead fulfilling and meaningful lives.

People were recognised as individuals and care was planned according to their personalities and interests. Staff supported people, to pursue their interests and achieve goals and aspirations by overcoming barriers and finding ways to ensure people participated in a wide range of age appropriate social activities. People were supported to be valued members of the local community. The interactive and stimulating environment provided was adapted to meet their individual needs and people benefitted from this. Staff enabled people to access specialist health and social care support in the community.

People were supported with their medicines in a manner that promoted their independence and achieved the best possible health outcome for them. They received a service that was safe for them to use, live and staff to work in. The provider and registered manager regularly reviewed the quality of the service, and changes were made to improve people’s care and support when required. This was in a way that best suited people. There were well-established working partnerships within the home that promoted people’s participation, independence, and reduced their danger of social isolation.

Right Care

People were given kind, compassionate care, and staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs and knew how to protect them from poor care and abuse. The service worked well in tandem with other agencies and staff were trained in how to recognise and report abuse and applied this, as necessary. People were able to communicate with staff and understand information given to them because staff supported them consistently, understood their individual communication needs and had the necessary skills to understand them. People could take part in activities, pursue interests that were tailored to them, were given opportunities to try new activities that enhanced and enriched their lives, and were supported to take positive risks.

Staff were appropriately recruited, and in sufficient numbers to support people to live safely, whilst enjoying their lives. Risks to people using the service and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. Staff who were trained, safely administered people’s medicines.

Right culture

The home’s culture was open, positive, and honest with a leadership and management that was clearly identifiable and transparent. The provider’s vision and values were clearly defined, and staff understood and followed them. Staff knew their responsibilities, accountability and were prepared to take responsibility and report any concerns they may have. The management and staff ethos, philosophy, attitudes, and behaviours meant people could lead inclusive and empowered lives. They received excellent quality care, support, and treatment because trained staff and specialists were able to meet their needs and wishes. Staff understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have and supported them accordingly. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive to them, and supported their aspirations to live a quality life of their choice. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well and people’s wishes, needs and rights were at the heart of everything staff did. The registered manager and provider enabled people and those important to them to work with staff to develop the service and staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

Rating at last inspection

The last rating for this service was Good (published 24 December 2018).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has improved to Outstanding. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Grasmere Avenue on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.