Heywoods Grange

Updated 15 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 14 June 2018 and was unannounced. The inspection was undertaken by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at information we already hold about this service including statutory notifications sent to us. Statutory notifications include information about important events, which the provider is required to send us by law. We used this information to plan the inspection. We reviewed the Provider Information Return (PIR) form. A PIR is a document that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with six people using the service, four relatives, four care staff and the registered manager. We observed the care provided throughout the day and reviewed two care plans and records relating to the management of the business.

Updated 15 August 2018

The inspection took place on 14 June 2018 and was unannounced. The last inspection to this service was on 21 August 2015. The service was rated good in each area we inspect against and good overall. Since the last inspection, there have been no changes to the home’s registration or registered manager. Following our most recent inspection we rated the service good overall with a requires improvement in the well led .

Heywood’s Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates ten people in one adapted building. The service is registered for adults with a learning disability and, or people with autism spectrum disorder. At the time of our inspection there were nine people using the service permanently and one person receiving respite care.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy

There was a registered manager in post. 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.

In summary we found: This was a well-established service which was well managed and run in the interest of people using it. Their needs and wishes were met and the staff worked hard to create a homely atmosphere and engage people both in the home and in the wider community. There was a regular staff team who knew people well and provided continuity to people across the day. The registered manager was also the owner and had run this service over many years and had given people security and opportunities to reach their full potential. The registered manger did have a deputy manager but they had left recently. This meant the registered manager was overseeing the care and support given to people as well as managing the staff. Although everyone felt really well supported we found some gaps in record keeping including staff training, induction and formal support. This had not impacted on staff’s ability to provide a good service. We found record keeping in other areas also required improvement. For example, in relation to a safeguarding concern there were no robust records supporting the actions taken by staff or any conclusions reached or lessons learnt as a result of the safeguarding concern. The service had not had any other incidents or accidents which could mean the service was well managed and risks were mitigated where possible. It could also mean staff were not accurately reporting incidents and accidents as it is unusual not to have any incidents all be it minor.

The staffing levels at the service were appropriate and people got the support they needed and had the opportunity to go out as they chose.

Medicines were administered as intended and there were robust systems of checking medicines to ensure they were not missed. Staff were suitably trained but records relating to staff’s competencies were not always in place.

Staff recruitment was good and staff received adequate induction, support and training to enable them to meet people’s needs. However, records did not always show us how this was achieved. Staff confirmed they had robust training and support.

Staff were aware of how to recognise and report safeguarding concerns to help ensure people were protected as far as possible from abuse.

Staff provided people with the necessary support and people’s care needs were planned and documented any risk or support a person might require. These plans were kept under review in light of any changed or unmet needs. People saw health care professionals as required.

Staff were motivated and had developed good relationships with the people they were supporting and extended this support to people’s family and friends. Staff supported people to maintain relationships of their choosing and to make their own decisions about this.

Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA ensures that people’s capacity to consent to care and treatment is assessed. If people do not have the capacity to consent for themselves the appropriate professionals, relatives or legal representatives should be involved to ensure that decisions are taken in people’s best interests according to a structured process.

People were supported to maintain good health and staff encouraged people to have a healthy lifestyle and participate in regular exercise. People were fully involved in menu planning and helped prepare meals for themselves and others they lived with.

Audits and feedback helped to identify what the service did well and where it needed to improve. There was a schedule of routine maintenance and refurbishment to help ensure the environment was fit for purpose and equipment safe to use. It was laid out well and provided homely, comfortable accommodation which was clean and people’s space was personalised.