Grange Care Services Limited - 27 Flamstead End Road

Grange Care Services – Flamstead End Road 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.

Grange Care Services -Flamstead End Road is a small residential centre registered to provide accommodation without nursing and accommodates up to six adults with learning disabilities in one adapted building.

The service had a registered manager who was also registered with CQC to manage another Grange Care Services learning disability service locally. 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. The registered manager was not at the service on the day of this inspection however, support was provided by the area manager and a representative of the provider.

When we last inspected the service on 14 January 2016 we found that the provider was meeting the standards assessed at that time. However, at this inspection we found that well led was an area that required improvement.

The provider's quality monitoring of the service had not identified areas of shortfall identified through this inspection and the management of the service was not always robust. Investigations into concerns raised with the service were not always robustly undertaken. CQC had not been notified of some incidents that had potential to affect people's safety and well-being which meant we could not check that appropriate action had been taken. Satisfaction surveys were distributed annually to relatives of people who used the service and relevant professionals.

We were advised that there were regular networking meetings held for registered managers within the provider's services to share good practice and explore ideas. However, the senior management team were not aware of updated sector guidance such as Registering the Right Support (RRS) which sets out CQC's policy on registration and variations to registration for providers supporting people with a learning disability and/or autism. This Guidance discusses the impact of RRS on inspections of relevant existing services.

People's demeanour indicated that they felt safe living at Flamstead End Road. Staff understood how to keep people safe. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines

were managed safely.

Staff received regular one to one supervision from a member of the management team which made them feel supported and valued and received training to support them to be able to care for people safely. People received support they needed to eat and drink sufficient quantities and their health needs were catered for with appropriate referrals made to external health professionals when needed. Staff understood their role in protecting people's rights in accordance with the Mental Capacity Act 2005 (MCA).

People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people's relatives had been involved in the planning of care where appropriate. Visitors to the home were encouraged at any time of the day.

The five questions we ask about services and what we found