Grange Court

Updated 29 August 2020

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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Grange Court 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave short notice of the inspection because of the Covid-19 pandemic. We wanted to ensure we could conduct our inspection while keeping people and staff safe.

What we did before the inspection

We reviewed and used information received from the service about their ongoing improvement actions and progress to plan and inform our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spent one day visiting the service and reviewed care plans, records and reports relating to the care people received. In addition, we looked around the home to check for infection control processes and maintenance of the property. We were unable to observe direct care interactions. This was due to Covid-19 good practice in an environment of this nature; also, because of the potential risk of causing increased anxiety for people in their home.

After the inspection

After the site visit, we spoke via video call with 11 members of staff, including the registered manager, regional manager and home supervisor. We received verbal and written feedback from relatives of the four people who live at the service. We also received written feedback from two health and social care professionals who have worked with the service.

Updated 29 August 2020

About the service

Grange Court is a residential care home for young adults with autism and learning disabilities. The service can support up to five people, at the time of the inspection four people lived at the service and were receiving personal care support.

Grange Court is a large adapted residential property, with an adapted layout to help meet people’s needs. People had their own bedrooms or self-contained flats with private bathrooms. People could also access communal areas of the home, including a dining room, lounge, kitchen and large garden. The home was designed to meet the principles of Registering the Right Support. This included being conveniently located so people had access to the local community and public transport links.

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

At the last inspection the key questions of Safe and Well-Led were rated inadequate. The key question Effective was rated requires improvement. There were breaches of Regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were due to shortfalls in the safety and leadership of the service, which meant people were at risk of harm and staff were receiving serious injuries. In addition, there were significant difficulties in recruiting and retaining suitable staff to ensure people received consistent care and support. At this inspection, we found vast improvements had been made and all breaches had been addressed.

We found there to be enough suitably trained and experienced staff to consistently meet people’s needs. Staff were recruited following safe recruitment processes and the registered manager interviewed applicants to ensure they demonstrated the appropriate values and motivation.

Risks to people’s safety were identified and assessed. Staff were encouraged to read risk assessments regularly, to ensure they supported people safely. There were multiple examples of people being supported to positive outcomes relating to their independence, with safe care and support. These included participating in activities around the home such as food and drink preparation and visiting places of interest for activities that they had not been to previously.

People were supported by staff who were confident in recognising and reporting any concerns of harm or abuse. Staff had received safeguarding training and any lessons learned were shared in supervisions and team meetings. There had been a reduction in the number of incidents where staff found people’s behaviours difficult to support. This showed the greater consistency in staffing and leadership at the home had positively impacted people’s wellbeing.

The staff team received the training and mentoring to ensure they had the skills and confidence to support people. Less experienced staff members were ‘buddied’ with experienced members to help role-model good practice and share knowledge.

People’s medicines were managed safely. Records were maintained and medicines were stored securely.

Infection prevention and control measures during the Covid-19 pandemic had been successful in ensuring people and staff did not contract any suspected or confirmed symptoms. There were daily and deep cleaning schedules in place which were thoroughly monitored. Staff had access to suitable personal protective equipment and had received additional training to help keep people safe.

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. Project work had taken place at the home to truly personalise mental capacity assessments and involve people in making specific decisions.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People’s communication needs were known and met, to enable them to actively participate in making decisions. People were supported to work towards positive outcomes and personal achievements, by a staff team who were knowledgeable and consistent.

There had been a change in registered manager and regional manager since the last inspection. In addition, newly appointed senior staff and a home supervisor were in post. Without exception, people’s relatives, staff and professionals spoke positively about the impact of the change in management team.

Thorough monitoring systems had been implemented. The registered manager had a thorough oversight of the service. The registered manager and leadership team were continually striving for a high standard of sustainable quality care and support at the service.

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 Inadequate (published 28 October 2019).

Why we inspected

We previously carried out an unannounced focussed inspection of this service on 14 and 19 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve

We undertook this focussed inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Good. This rating change 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 Grange Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.