26 April 2022
During an inspection looking at part of the service
About the service
Noble Grange is a care home providing accommodation and personal care to up to 11 people. The service provides support to autistic people, people with a learning disability and people with mental health needs. At the time of our inspection there were 11 people using the service. The building was designed by leading architects for people with a learning disability and autistic people. There are spacious corridors with a variety of communal spaces with low stimulus décor. There are seven bedrooms with ensuites split over two floors in the main house and four self-contained apartments.
People’s experience of using this service and what we found
People and their relatives told us people were safe from the risk of abuse. The provider had effective safeguarding systems in place and promoted a culture which empowered people to speak up. Any concerns raised were dealt with promptly and included thorough investigations and referrals to external agencies such as the local safeguarding team.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider was a committed member of The Restraint Reduction Network which aims to reduce reliance on restrictive practices in health and social care. Any restrictions in people’s care were continually reviewed to ensure they remined ethical, legal and proportionate.
People received their medicines as prescribed. The providers robust systems and processes ensured medicines were ordered, stored, administered and disposed of safely. Medicines were reduced where appropriate which ensured people's behaviour was not controlled by excessive and inappropriate use of medicines.
Risks to people’s physical health and emotional wellbeing were identified, assessed and managed safely. Some people had complex conditions which required very careful and considered care planning to minimise the likelihood of distress. Each person had a detailed ‘Positive Behaviour Support’ care plan which focussed on understanding the person and how to respond proactively to the person’s needs to increase their quality of life.
Based on our review of our key questions safe and well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support: The model of care and setting maximises people’s choice, control and Independence.
Right care: Care is person-centred and promotes people’s dignity, privacy and human rights.
Right culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
There were enough staff to keep people safe. Staff rotas were designed around the needs of people which enhanced their social and emotional wellbeing. Robust recruitment decisions were made to ensure staff had the right values to provide safe and empowering support to people.
People and their relatives spoke positively about the leadership at the home. Staff told us they were supported by the registered manager who always listened and acted on any concern. The provider welcomed external scrutiny in order to drive improvements.
The provider and registered manager worked in partnership with other healthcare professionals to ensure people received high quality care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 February 2019)
Why we inspected
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.