Cartmel Grange

We assessed the quality statements from all the key questions; safe, effective, caring, responsive and well-led and we found the service had made improvements and is no longer in breach of regulation. Therefore, the overall rating for this service has improved from requires improvement to good. Staff now assessed and mitigated risks. Care plans now guided safer practice. Under new leadership the service had improved the management of the overall quality and safety of the service.

People were protected and kept safe. There were improved and more detailed care records capturing a variety of risks associated with care and treatment. Staff were aware of their safeguarding responsibilities. There were enough staff with the right skills, qualifications and experience. Staff received training and supervision to support them in delivering safe and effective care. During the assessment we identified some concerns with the management of risks in the environment and with the management of medicines. These were addressed by the provider and registered manager straight away and they provided evidence of how they did this. The home was clean and well presented.

People were fully involved in assessments of their needs. Staff regularly reviewed these assessments taking account of people’s communication, personal and health needs. Staff involved people and those important to them in their care planning and decisions were made in people’s best interests where they did not have capacity to do so themselves. Where some people required a modified diet records were not always clear or followed in line with professional guidance. During the assessment a full review of those nutritional needs was completed, and the management took action to ensure people’s needs were met in line with current standards and evidence-based guidance. The staff team worked well with other organisations and services to support people to manage their health and wellbeing.

People were treated as individuals and with kindness, dignity and compassion. People had choice in their care and were encouraged to maintain their independence. Staff responded to people in a timely way. Staff ensured people received compassionate care and took the time to get to know them well. People’s personal, cultural, social and religious needs were fully supported. People were regularly supported to engage in meaningful activities and interests and maintain relationships with family and friends. The provider and registered manager cared about and promoted the wellbeing of their staff and supported and enabled them to deliver person-centred care.

The service worked well with commissioners to ensure that continuity of care for people was managed. People’s individual communication needs were identified, and information was provided in an accessible way. People and their relatives were able to give feedback on care which the provider listened to and acted on. Staff understood about equality and diversity. The service contacted emergency services when required and knew when to involve specialist services in people’s care. There was a system in place for responding to concerns or complaints. People’s end-of-life wishes were noted and reflected in their care records.

The management team led the service with integrity, openness and honesty and valued diversity in their workforce. Staff felt very supported by the registered manager and were able to report concerns and said they were listened to. There was a range of quality monitoring and auditing processes in place. However, some issues seen during the assessment by the inspection team had not been identified through the provider’s oversight processes. The provider and registered manager took immediate action to improve the processes to ensure capturing and rectifying those areas of concern. Management demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them the staff and people using the service. Staff understood their roles and responsibilities. The registered manager worked with the local community to deliver the best possible care and were receptive to new ideas. The provider and registered manager worked well together with a focus on delivering good care and improving systems.