Archived: Apley Grange

Apley Grange is owned by the Society of the Holy Child Jesus which is a religious community of Roman Catholic sisters. The home is registered to provide residential and nursing care for up to 42 people. The service is spilt into three distinct areas; Hilda House which provides support for people who live relatively independently, Margaret’s House which provides nursing care and Cornelia House which accommodates people living with dementia, some of whom require nursing care. Apley Grange is set in extensive grounds and is a short distance away from Harrogate town centre.

At the time of our inspection there were 37 people living at the service.

The service had a manager in post who had submitted an application to the Care Quality Commission to become the registered manager. 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 told us they felt safe and that they trusted the staff caring for them. There were sufficient staff available to meet people’s needs and people were also supported by a pastoral team who were available 24 hours a day to provide religious and emotional support.

The manager and staff knew how to safeguard people and protect them from avoidable harm. Staff had received up to date safeguarding training and were confident any concerns they raised would be investigated appropriately. Risks to people were identified with risk management plans in place to ensure people received the support they needed to stay safe.

Medicines were safely managed. Some people were supported to manage their own medicines. Where this was the case clear risk assessments were in place.

Staff were provided with the support, training and supervision they needed to deliver effective care.

The service followed the principles of the Mental Capacity Act (2005). Detailed mental capacity assessments were completed and we saw evidence the service had taken all practical steps to support people to make their own decisions. Where people were unable to make an informed decision there were best interest decisions in place which took into account their previous known wishes.

People told us the food was of a good standard and lunch time was a relaxed and enjoyable experience.

The décor throughout the service was to a high standard. All areas of the service were light and airy and there was lots of interesting art work on the walls for people to enjoy.

Everyone we spoke with described a high standard of care. People told us kindness and compassion was integral to the service.

Plans were made to support people to direct their care at the end of their life and the service focused on the celebration of life.

There was a strong sense of community within the service and support based on mutual respect. Care plans focused on the strengths people had and what they offered to the service as well as the support they required to live well.

Care planning documentation was in the process of being updated and the new care plans we reviewed were much improved.

People had access to a range of meaningful activities which they told us they enjoyed. Support from a pastoral team complimented the support provided by nursing and care staff and focused on ensuring people’s religious needs were met.

The manager had worked at the service for a number of years, although they were relatively new to the role of manager. People, staff and visitors spoke with confidence about them and described feeling well supported.

The service had an open and transparent culture and there were effective systems in place to monitor the quality of the care provided.

Is the service safe?

People had been cared for in an environment that was safe clean and hygienic. There were enough staff to meet the needs of the people living in the home.

Staff files contained all the information required by the Health and Social Care act 2008 and demonstrated that the staff had the skills and experience needed to support the people living in the home.

Is the service effective?

People told us that they were happy with their care and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood the peoples care needs and there was good continuity of care. One person told us that they "couldn't be happier".

Is the service caring?

People received care from caring and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. One person told us that "everyone is so kind and helpful".

Is the service responsive?

Peoples needs were assessed on admission, and each person had a named key nurses and carer. People had access to activities that met their social, intellectual and spiritual needs.

Is the service well led?

People told us that they were asked to give feedback on the service. Regular audits were carried out by the management team to ensure quality standards were maintained.

People were protected from the risks of inadequate nutrition and dehydration. We saw that staff had access to a range of tools that were used to identify and monitor those people at a greater risk of poor nutrition and dehydration. People told us the food was excellent.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. All staff had received training and demonstrated a good understanding of safeguarding adults from abuse.

We looked at the medicines records and stocks for three people's controlled drugs and found these to be correct. We also checked the records and stocks for a range of other medicines for six people. Records were complete and medicines could be accounted for. This meant that medicines were prescribed and given to people appropriately.

People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. Records showed a range of systems that were in place to monitor how the service was being run.