CQC report explained · a residential care home
What the CQC found at Grammar School House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found personalised risk assessments, safe medicines procedures, suitable staffing and regular safety checks.
- Effective?
- Good
- Staff had the training and support needed for their roles. People's nutritional, health and communication needs were assessed and supported, including support from relevant health professionals.
- Caring?
- Good
- Staff were described as kind, committed and compassionate. Inspectors saw people being treated with dignity and supported to express their views and make choices.
- Responsive?
- Good
- Care plans reflected people's preferences, needs and communication methods. Staff supported people to take part in activities, maintain relationships and use local community facilities.
- Well-led?
- Good
- The provider and management had clear systems for checking quality and making improvements. Relatives, staff and health professionals spoke positively about the leadership and the changes made since the last inspection.
What inspectors found, July 2019
Rated Good; inspectors found kind, person-centred care and effective management after improvements since the previous Requires Improvement rating.
This was a planned inspection over two days. One visit was unannounced and the other was announced. Inspectors met all 10 people living at the home, spoke with relatives, staff and health professionals, and checked care, medicines, training and management records.
The inspectors found people were safe and received their medicines as prescribed. Staff understood people's health, communication and support needs. Care plans were personalised, and people were supported with food, healthcare, activities, relationships and choices.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home was rated Requires Improvement at the previous inspection published on 11 June 2018. Inspectors said the provider had acted on the earlier findings and made the required improvements.
Kind and respectful staff
Relatives and health professionals described staff as caring and dedicated. Inspectors observed staff adapting their approach to support people's wellbeing, dignity and individuality.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Person-centred support
Care plans covered people's preferences, communication, health needs and routines. Relatives were involved in planning and reviewing care.
“People had a person-centred care plan, which detailed their preferences about the way they wanted staff to give them care and support.” from the report
Community activities
People were supported to follow their interests and take part in meaningful activities, work and community life.
“Staff were supporting people to follow their interests and to take part in meaningful activities, which they tailored to their abilities, to ensure their well-being.” from the report
Good health support
Staff worked with health professionals and acted on changes in people's health. Relatives said staff responded quickly during health emergencies.
“People were supported to maintain good health and had access to a range of health care professionals including behaviour specialist, specialist nurses, GPs, and epilepsy services.” from the report
Improvements since the last inspection
The provider acted on the previous inspection findings. Inspectors said these changes helped the home achieve its Good rating.
“Since our last inspection the provider had acted on the findings, making the required improvements which were instrumental in achieving an overall 'Good' rating.” from the report
Refurbishment was still ongoing
minorThe building was still being refurbished at the time of the inspection. Ask what work remains and whether it could affect your relative's room, routines or comfort.
“The service was an adapted historic school house, bigger than most domestic style properties, but with ongoing refurbishment” from the report
Recruitment and staff turnover
minorThe home was recruiting, and some vacant shifts were covered by its own staff or the same agency staff. The report also says staff turnover had been affected by changes in the home's culture.
“Whilst the service was proactivity recruiting, vacant shifts were covered using their own staff, or the same agency staff” from the report
- 01What refurbishment work is still planned, and how will it affect residents during the work?
- 02How many permanent staff currently work at the home, and how often are agency staff used?
- 03How would you support my relative's particular communication needs, including any non-verbal communication?
- 04How would you support my relative to take part in activities and use facilities in the local community?
- 05How are medicines, including 'as and when required' medicines, reviewed and monitored?
This was a planned inspection of the whole care home, including both the premises and care provided, and all five CQC questions were rated. This explanation was written from the published report of 5 July 2019 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, June 2018
Grammar School House was rated Requires Improvement; inspectors found kind, person-centred care but shortfalls in safety, effectiveness and management.
The inspection was unannounced and took place on 15 and 21 March 2018. Inspectors observed care, spoke with people, relatives, visitors and staff, and reviewed care plans, medicines, staffing records, training, complaints and quality checks.
The home was caring and responsive. Staff knew people well, treated them kindly, supported their choices and helped them take part in activities and community life. People had detailed care plans and good access to health professionals.
Improvements were needed in safety, effectiveness and leadership. Inspectors found risks with some bathroom locks, incomplete records of one-to-one staffing, medicines being given in ways that did not always protect dignity, and staff not always following guidance about choking risks and fluids.
The overall rating changed from Good at the September 2015 inspection to Requires Improvement. This means the home was not consistently meeting the expected standard, although inspectors found some good care and the manager agreed to address several issues.
Kind staff
Inspectors saw warm, respectful relationships. Staff knew people's routines, preferences and communication needs.
“Staff were kind and compassionate in their approach.” from the report
Detailed care plans
Care plans included people's histories, preferences, communication methods and the support they needed with daily activities.
“They had detailed and informative care plans which provided guidance to staff on their needs and preferences.” from the report
Health support
People were supported to attend health appointments and receive specialist care. Staff communicated with health professionals and relatives about people's wellbeing.
“People had good access to healthcare and were supported to lead healthier lives.” from the report
Activities and choice
People were supported with hobbies, community access and independent living skills. Some people had jobs or regular activities outside the home.
“People were supported to follow their interests and we saw that they had an individual planner which set out planned activities and suggestions.” from the report
Environmental safety
seriousSome bathroom locks could not be overridden in an emergency. A portable radiator also posed a possible falls risk. The manager later said the bathroom locks had been changed.
“some of the bathroom doors had locks of a type that could not be overridden in the event of an emergency” from the report
Choking risk
seriousStaff did not follow the guidance for one person at high risk of aspiration. The manager arranged more training and planned to follow up with the speech and language therapy team.
“we observed that the individual was served a toasted sandwich which was not suitable as they were at high risk of aspiration.” from the report
Staffing records
needs fixingThere were enough staff on the inspection days, but records did not show clearly that everyone always received their assessed one-to-one staffing hours.
“we were not always confident that everyone living in the service was receiving their assessed levels of staffing.” from the report
Medicines and dignity
needs fixingPeople received their medicines as prescribed, but inspectors saw medicines given during a meal and one person's tube-administered medicines being given in a communal area.
“People's medicines were managed safely but not always administered in a way which promoted peoples dignity.” from the report
Quality checks
needs fixingAudits covered areas such as medicines, health and safety and quality, but they had not identified all the issues found during the inspection.
“these processes had not identified some of the areas that we found at the inspection” from the report
Mealtimes and fluids
minorOne dining area offered little visible choice and drinks were delayed until after the meal. Fluid records for one person were not always totalled.
“The dining room in one part of the service was part way through a refurbishment, and lunch was a rather subdued event with people eating a similar meal with little evidence of choice.” from the report
- 01How do you now record and check that each person receives all of their assessed one-to-one staffing hours?
- 02What changes have been made to ensure staff follow each person's choking, food texture and fluid monitoring guidance?
- 03How are medicines, including medicines given through a PEG, administered in a way that protects privacy and dignity?
- 04Have all bathroom locks and other environmental risks been checked to ensure they are safe in an emergency?
- 05How do your current quality audits identify problems that were missed at the inspection?
This was an unannounced inspection covering all five questions and the overall service rating, including care, medicines, staffing, premises, records and management systems. This explanation was written from the published report of 9 June 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.
Every inspection of Grammar School House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 5 August 2011.
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.
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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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