Grande Care Ltd

This assessment was carried out to follow up on action we told the provider to take at the last assessment. During this assessment we spoke with people who used the service, their relatives, staff, the registered manager and sought feedback from other healthcare professionals. We looked at care plans, recruitment files and quality assurance records. The provider was previously in breach of the legal regulations in relation to safe care and treatment and good governance. Improvements were found at this assessment and the provider was no longer in breach of these regulations.

Following our last inspection, the registered manager had completed further qualifications to ensure their effective management of the service and compliance with legislative requirements. The registered manager had worked with people, their relatives and staff to build a culture focused on putting people at the centre of their support and where staff felt able to speak up, confident their voice would be heard. Staff described the registered manager as visible, supportive and encouraging of their professional development.

Risks to people's health had been identified and there was a joined-up approach to risk management. Staff understood their role in keeping people safe and reporting any concerns they had about people’s health, wellbeing or safety. Checks were in place to ensure staff followed current best practice to reduce the risk of any infections spreading. Staff received training on medicines administration which included checks of their competency. Improvements had been made in the management of ‘as required’ medicines. However, we found medicines care plans required more detail to reflect people’s capacity and independence and to ensure accurate records were maintained.

People had a robust assessment of their needs before they began using the service to ensure their needs and preferences could be effectively met. The registered manager made referrals to, and worked with, other external health and social care teams which helped to ensure continuity of care. Staff described good communication and teamwork to ensure people received the support they needed, when they needed it.

People received support that was tailored to their individual needs and delivered by a core team of staff who knew them well. The registered manager promoted effective communication and recognised the importance of providing people and their families with regular opportunities to share their feedback about the service provided.

People's equality and diversity needs were understood and supported by the service. Staff gave people choices about how they lived and were able to explain how they enabled people to maintain independence in their home.

The registered manager had a 12-month service improvement plan with planned strategies and budgets for achieving the actions identified.