Archived: Heather Grange

At the last inspection in January 2015 we rated the service as good. At this inspection we found the service remained good.

People living in the home consistently told us they felt safe and staff treated them well. People were supported by enough skilled staff so their care and support could be provided at a time and pace convenient for them. Appropriate recruitment procedures were followed to ensure prospective staff were suitable to work in the home. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and welfare had been assessed and preventive measures had been put in place where required. People's medicines were managed appropriately and according to the records seen, people received their medicines as prescribed by health care professionals.

Staff had the knowledge and skills required to meet people's individual needs effectively. They completed an induction programme when they started work and they were up to date with the provider's mandatory training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them. A visiting healthcare professional provided us with positive feedback about the service.

Staff treated people in a respectful and dignified manner and people's privacy was respected. People living in the home had been consulted about their care needs and had been involved in the care planning process. We observed people were happy, comfortable and relaxed with staff. Care plans and risk assessments were person centred and provided guidance for staff on how to meet people’s needs and preferences. There were established arrangements in place to ensure the care plans were reviewed and updated regularly.

The service was responsive to people’s individual needs and preferences. People were supported to follow their interests and take part in a wide range of social activities. The activities were designed to stimulate conversation, promote interaction with others, maintain personal interests and to have enjoyment. People, families and staff had regular meetings to discuss the operation of the home. They were also invited to be members of forums which focused on specific issues such as safeguarding and food.

Each person's needs were assessed and care records had personalised information about how to meet them. Care was focused on people's wishes and preferences and people were supported to remain active and independent. Staff felt the information available to them enabled them to offer care in the way each person wanted.

People were provided with a safe, effective, caring and responsive service that was well led. The registered manager provided strong, effective leadership to her team. Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care.

People were satisfied with the care provided, one person said, 'Everyone is kind and thoughtful'. We found people's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. We looked at ten people's care plans in detail during the visit and noted they were comprehensive and covered all aspects of need.

Staff had an understanding of safeguarding vulnerable adult procedures and knew who to contact in the event of a concern. Policies and procedures were readily available for staff reference in each suite.

There were sufficient staff on duty to meet people's needs and there were systems in place to review the staffing levels at regular intervals.

During the inspection we found, people and their relatives were satisfied with the service provided, one person told us, 'The home is lovely, the staff are very nice and do what they can for you'. People had individual care plans which were supported by a series of risk assessments and daily care records. However, we found sections missing in two people's care plans, which meant it was unclear how care had been planned to address particular aspects of their care.

People were provided with a variety of suitable and nutritious meals. All people spoken with made complimentary comments about the food. We found a person who required a special diet was provided with appropriate food and staff had a good knowledge of the person's dietary requirements.

There were policies and procedures in place to safeguard people from harm and staff had received training on the protection of vulnerable adults. However, we found a safeguarding incident had not been referred to the local authority.

We looked in detail at the staffing levels in the home and found there were three occasions when the nurse carried out a sleeping in duty and there was no nurse on waking duty. This meant people living on the nursing unit were not receiving active nursing care during the night on these occasions.

There were systems in place to ensure staff received appropriate training and support.

We found people were satisfied with the service they received, one person told us, 'I'm happy with everything, the staff are very good and the home is lovely' and another person commented, 'I have no complaints, it's very nice here'. People told us the staff were attentive and answered the call system in a timely manner.

People had individual care plans which were supported by a series of risk assessments. People told us they had discussed their needs with staff and had been involved in the care planning review process. Systems had been put in place on Garden unit to closely monitor people's wellbeing and nurses had been allocated to review specific people's care plans on a regular basis.

People were provided with a varied programme of activities which were offered on a daily basis. People spoken with told us they enjoyed the activities and they looked forward to them each day.