Archived: Appleby Grange

Updated 12 April 2016

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.

This was an unannounced inspection that took place on Thursday 18 February 2016. The inspection team consisted of the lead adult social care inspector and a specialist nurse advisor. The specialist advisor was a fully trained nurse with experience of the care of older adults and people living with dementia. This was the first inspection of this service since it was registered with Brancaster Care Homes Limited in August 2015.

Together the team met with all of the twenty two people living in the home and with three visiting relatives. We spent time in lounges and shared areas and we observed the care delivery. We looked at ten care files which included assessments, reviews of care and care plans.

We also met with the newly appointed manager, the deputy manager and a project manager for the service. We spoke with six care staff, a nurse and with three domestic staff and the cook. After the inspection we spoke with the operations manager and with the provider.

We looked at six staff files. These included information about recruitment and staff development.

We looked at quality monitoring records, the fire log book and food safety records.

Updated 12 April 2016

This was an unannounced inspection that took place on 18th February 2015. This was the first inspection of the service since it was registered to Brancaster Care Homes Limited in August 2015.

Appleby Grange is a care home with nursing that is registered to take up to twenty seven people. The service supports older adults, younger people in need of nursing care and people living with dementia. Accommodation is on one floor with mainly single occupancy rooms. One room may be shared by two people. Rooms have ensuite toilet facilities. The home has suitable lounge and dining areas. The home is situated in a residential area of Appleby and is near to the amenities and the transport links of this small Lakeland town.

The home had a registered manager who was going to step down from the post. A new manager was in place and she was preparing to apply for registration. 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.

Safeguarding was appropriately managed in the service and staff had received suitable training. Staff said they understood how to contact the company and external organisations. People told us they felt safe.

Risk assessments were in place along with emergency planning. Accidents and incidents were recorded and analysed. Some fire safety needed to be updated to ensure all risks were reduced.

We made a recommendation that a check was completed to ensure that all staff members had received appropriate fire drills and instructions.

Staffing levels were suitable. Recruitment and disciplinary actions were in place and ensured good staffing arrangements.

Medicines were managed fairly well but some records had not been signed. The manager was dealing with these issues.

We recommended that medicines audits continue and that failure to record administration be dealt with.

Infection control was managed appropriately.

All of the staff team had undergone what Brancaster Care considered to be mandatory training for their care and nursing staff. Supervision, appraisal and staff development was underway.

Steps were being taken to ensure that the service met with the requirements of the mental Capacity Act 2005. Restraint was not used in the service.

People who lived in the home received good levels of hydration and nutrition. The food was of a high quality.

The building was being refurbished with decorating, building work and replacement fixtures and fittings underway.

Staff were caring, respectful and kind. People told us they were treated with dignity and their privacy was maintained.

Care planning was being developed to ensure that people got the support they needed and wanted.

People told us they had suitable activities and entertainments and that more activities were being planned.

Complaints were handled correctly.

The service was in transition in relation to the registration of a manager. The new manager was a suitably experienced and qualified person.

The company had a suitable quality monitoring system and we had evidence that this was in place in the home.

The service reflected the vision and values of the company.

There had been considerable changes made in the six months since Brancaster bought the home and more were planned.