This inspection took place on 14 January 2019 and was unannounced. This meant the staff and provider did not know we would be visiting.

Grangewood Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Grangewood Care Centre provides accommodation and personal care for up to 50 people across two floors in one purpose built building. Some of the people were living with dementia. On the day of our inspection there were 49 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Accidents and incidents were appropriately recorded and risk assessments were in place. Staff understood their responsibilities with regard to safeguarding people and had been trained in protecting vulnerable adults.

The home was clean and regular health and safety audits were carried out. Appropriate arrangements were in place for the safe administration and storage of medicines.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were protected from the risk of poor nutrition. Care records contained evidence of people being supported during visits to and from external health care specialists.

People and family members were complimentary about the standard of care at Grangewood Care Centre.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Support plans were in place that recorded people’s plans and wishes for their end of life care.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support and their individual wishes, needs and choices were considered.

Activities were arranged for people based on their likes and interests, and to help meet their social needs.

The provider had an effective complaints procedure in place, and people were aware of how to make a complaint.

The provider had a robust quality assurance process in place. Staff said they felt supported by the registered manager. People, family members and staff were regularly consulted about the quality of the service via meetings and surveys.

Grangewood Care Centre is owned and run by Care UK Community Partnerships Ltd. It is a large two storey residential care home situated in Houghton-Le-Spring. The service provided accommodation, personal care and support to 50 older people. At the time of our inspection the home was full.

This inspection took place on 14 and 15 June 2016 and was unannounced. This means the provider or staff did not know we would be visiting. We last inspected this service in December 2013, at which time we found them to be compliant against all of the regulations that we inspected.

The service had a registered manager in post. 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.

There was a safeguarding policy in place and the staff we spoke with understood their responsibilities with regards to protecting people from harm or improper treatment. People told us they felt safe living at Grangewood Care Centre with support from the staff. Relatives confirmed this. We reviewed the staffing levels and found them to be appropriate. People, relatives and staff told us they felt there was enough staff to meet people’s needs safely.

Corporate policies, procedures and systems were in place to assist the staff to deliver safe, good quality care. We found electronic care records and staff records were accurate, detailed and up to date. Some care monitoring charts completed by care workers were not as comprehensive as they should be and this was to be addressed by the manager.

Personal emergency evacuation plans were in place and checks on the safety of the premises were carried out by maintenance staff and by external professionals as necessary.

Medicines were managed in line with safe working practices. We saw medicines were administered safely and medicine administration records were accurate and well maintained.

The registered manager and staff had a thorough understanding of the Mental Capacity Act (MCA) and their own responsibilities. The majority of people living at Grangewood lacked the mental capacity to make important decisions and the registered manager had applied to the local authority for deprivation of liberty authorisations. Other decisions which were made in people’s best interests were carried out in line with legislation and guidance.

People were supported by staff to maintain a healthy and well-balanced diet. The catering was managed well and the food looked nutritious and appetising.

Staff received an induction upon commencement of employment and were trained in key topics to ensure they had the skills and knowledge to support people. Staff were also supported through regular supervision and appraisal. Staff told us there was good morale and they worked well as a team.

Staff displayed caring attitudes and treated people as individuals. We observed people were respected and their privacy and dignity was maintained by the staff who supported them. We saw staff gave people choices and encouraged them to make decisions where possible.

The service had adopted a person-centred approach and the care and support provided by staff was tailored to suit the individual needs of each person. The service offered a wide range of activities and supported people to maintain family and community links by welcoming visitors into the home. People and their relatives told us they knew how to complain and said they wouldn’t hesitate to do so if necessary.

‘Resident and Relative’ meetings and annual surveys were used to gather opinions and feedback from people and their relatives about the service they received. The registered manager and provider carried out audits which showed they were monitoring the safety and quality of the service and action plans were devise

During our previous visit we identified that care records were not always accurate or up to date.

During this visit we found that care records were regularly reviewed and audited by the manager and staff had received training in documentation and record keeping.

We did not speak to people during this visit.

People living in the home made positive comments about the support they received from staff at Grangewood Care Centre and about the premises. One person said “The bedroom has everything I need and I like having my own toilet.”

We saw that staff supported people in a sensitive and engaging way and regular activities were arranged. One visitor told us, “There always seems to be entertainment or something going on. They had a music concert on the other day.”

The home had systems in place to regularly check the quality of care and other services and actions had been taken where issues had been identified. Residents and relatives were regularly consulted for their views about their care and treatment.

We saw that assessments of needs were used to plan the support that people needed however people’s care records were not always accurate or up to date. We also found inconsistency with the handover process which meant that important information about people’s well-being could be missed.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

People we spoke with who lived at the service were generally positive about the care they received at Grangewood Care Centre. One person we spoke with told us "I love my room, it has all my things in it including my photographs". Some people had keys to their rooms and one person told us "I like having a key its my own space".

Some people we spoke with told us they got along better with some staff within the home but confirmed that nobody was rude to them. We saw that people were offered hot drinks regularly during the day and that staff attended to people promptly if they required assistance.