CQC report explained · a residential care home
What the CQC found at Grace House Care Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2018
Rated Good; inspectors found safe, kind and personalised care, with one medicines process improved after the visit.
This was an unannounced inspection on 9 January 2018. Inspectors spoke with 11 people, one relative and staff. They observed care and checked care plans, medicines, accidents, staff records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe and were treated kindly. Staff supported people's choices, independence, health needs, activities and end of life wishes.
The previous inspection in October 2016 found breaches about governance and consent. The provider had made the required improvements by this inspection. Inspectors also found that clear protocols for some as-required medicines were not in place, but the provider supplied evidence after the inspection that this had been addressed.
Personalised support
Care plans recorded people's needs, preferences, routines and life stories. Staff used this information to provide individual support.
“Care was planned in a person-centred way.” from the report
Activities suited to interests
The home had improved its activities since the previous inspection. People could join group activities or receive one-to-one activities in their rooms.
“People had access to a wide range of activities and outings.” from the report
Improved management systems
The provider had introduced stronger audits and electronic records. Inspectors found that identified improvements were acted on.
“Regular audits were carried out to monitor and assure the quality of the care that people received.” from the report
As-required medicines guidance
needs fixingInspectors found that clear protocols were not in place for some medicines given only when needed. The provider later sent evidence that protocols had been put in place.
“Where people were prescribed 'as required' (PRN) medicines, we noted there were not clear protocols in place for staff.” from the report
- 01How are protocols for as-required medicines kept up to date and checked?
- 02How will you make sure the improvements to governance and consent found at this inspection continue?
- 03How are people's individual activity plans reviewed when their interests or abilities change?
- 04How are relatives involved in best-interest decisions when someone cannot make a specific decision?
- 05How are falls and other incidents reviewed, and how are changes to care plans put into practice?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 3 February 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2017
Grace House Care Home Limited is rated Requires Improvement; care was safe and kind, but mental capacity records and quality checks were not good enough.
This was an unannounced, comprehensive inspection on 27 October 2016. Inspectors reviewed care records, medicines, staff files, training, audits and policies. They spoke with people living at the home, relatives, staff and the manager.
The home was rated Good for Safe and Caring. Inspectors found enough staff, safe medicines administration, suitable recruitment checks and good safeguarding arrangements. People described staff as kind, patient and respectful, and said staff knew them well.
The home was rated Requires Improvement for Effective, Responsive and Well-led. Staff were not consistently following the Mental Capacity Act. Activities did not meet everyone's needs, and quality checks were not strong enough to find problems. The provider breached two legal regulations.
Safe medicines
Medicines were administered safely and as prescribed. Records were up to date and allergies were documented.
“At this inspection we found that people's medicines were administered safely.” from the report
Enough staff
Inspectors found enough staff to respond to people's needs without rushing. Recruitment checks were also completed.
“There were sufficient staff present to meet people's care needs.” from the report
Kind care
Staff treated people warmly and compassionately. They supported privacy, dignity and independence.
“Interactions between people and staff showed kindness and compassion.” from the report
Person-centred care
Care plans included people's needs, routines and preferences. Staff knew people well and adapted support when needs changed.
“Care plans were person-centred and information on what was important to people was clear.” from the report
Mental capacity decisions
seriousRestrictions were used before people's capacity had been assessed, and best interest decisions were not recorded. This breached Regulation 11.
“The lack of mental capacity assessments and records of best interest decisions was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak quality checks
seriousAudits did not contain enough detail and failed to identify problems found by inspectors. This breached Regulation 17.
“The quality assurance processes were still not robust enough to identify issues and improve the quality of care.” from the report
Activities
needs fixingSome people had little to do, outings were not regular and the environment could be confusing for people living with dementia. Inspectors recommended improvements.
“We recommend that the activities on offer cater for all people and the types of activities and environments created are sensitive to the needs of people living with dementia.” from the report
Care plan reviews
needs fixingNot all care plans were reviewed regularly, although they were updated when people's needs changed.
“We noted that not all care plans were being regularly reviewed.” from the report
- 01How are decision-specific mental capacity assessments and best interest decisions now completed and recorded?
- 02How do you check that any restrictions on a person's freedom are legally authorised and in their best interests?
- 03What changes have been made to quality audits so they identify problems with care plans, medicines and consent?
- 04What activities are available for people living with dementia, and how often can residents go out?
- 05How often are care plans reviewed, including when local authority reviews do not take place annually?
This was an unannounced comprehensive inspection covering all five CQC questions and checking whether action from the November 2014 inspection had been completed. This explanation was written from the published report of 10 January 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Grace House Care Home Limited
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- February 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Grace House Care Home Limited →
- January 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Grace House Care Home Limited →
- October 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2013
Registered with the Care Quality Commission on 2 September 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
77 live-in carers within about an hour of Surrey
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,250 a week. 66 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“Not only has she looked after him beautifully, she has also been great company for him with lively conversation, kindness and humour.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.