This was an unannounced inspection which took place over two days on the 16 and 22 August 2017. The Granleys provides accommodation and personal care for up to 17 people with a learning disability and a sensory or physical disability. At the time of the inspection there were 16 people living there.

The Granleys has a registered manager who was absent during our inspection. A representative of the provider was present. 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.

At the last comprehensive inspection, the service was rated as requires improvement. At this inspection we found the service was good and the service had made improvements to infection control systems and recruitment processes. They had also made improvements to the care planning processes and people were being treated with dignity and respect.

Quality assurance systems were in place to monitor the quality of care people received and to identify any shortfalls in the service. However, some improvement was needed to ensure all aspects of the service would be audited so that action would be taken to address these issues promptly. The representative of the provider took action during the inspection to ensure the appropriate pre-employment checks would be completed as part of their recruitment processes. They also made sure checks for fire systems and water temperatures were being carried out at the appropriate intervals. Quality assurance systems included feedback from people living in the home, their relatives and staff. Improvements made over the past 12 months to the environment, infection control systems, care records and staff support had been maintained.

People were supported by sufficient staff to meet their needs. Staff had access to training to acquire the skills and knowledge to support people. They had individual and group support to reflect on their roles and professional development. Staff had a good understanding of people’s needs and treated them respectfully and with kindness.

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 support this practice. People’s care was individualised reflecting their individual needs, preferences and lifestyle choices. Their care was discussed with them and their care records were kept up to date with their changing needs. People were supported to stay healthy and well through access to health care professionals and a healthy diet.

People’s rights were protected and they were kept safe from the risk of injury or harm. Any accidents or incidents were analysed and the appropriate action was taken to prevent them happening again. People who became anxious or upset were supported to manage their emotions. People’s medicines were administered at times to suit them. Medicines systems were monitored closely to ensure they were managed safely. People had access to a range of activities which were meaningful and reflected their choice and interests. They were actively involved with their local community using places of worship, the library, sports facilities and shops.

The registered manager and the representative of the provider were open and accessible. People and staff were confident talking with them about any issues or concerns. People knew how to raise concerns and complaints information was accessible to them. The management team were aware of the challenges of recruiting and keeping staff. The staff team spoke positively about their support and the care they provided.

This was an unannounced inspection which took place on the 23 February 2017. The Granleys provides accommodation and personal care for up to 17 people with a learning disability and a sensory or physical disability.

We undertook this focused inspection on 23 February 2017 to check that they had followed their plan and to confirm that they now met legal requirements in relation to a breach of regulation 15. This report only covers our findings in relation to these issues. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Granleys on our website at www.cqc.org.uk”

There was 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.

At the unannounced focused inspection of this service on 4 January 2017 a continuing breach of legal requirements were found. After this inspection, we asked the provider to take action to make improvements to:

• Infection and control systems within the home and we found these improvements had been met.

The Department of Health’s guidance on the prevention and control of infection in care homes had been followed. A cleaning schedule was in place providing clear guidance about the standard expected to maintain the cleanliness of the environment, equipment and fixtures and fittings. An annual statement had been produced to summarise infection prevention and control measures in the home. The management of the laundry had improved, new bins had been supplied with lids and additional quality assurance measures had been put in place to ensure infection control measures and the cleaning of the home were being sustained.

This was an unannounced inspection which took place on the 4 January 2017. The Granleys provides accommodation and personal care for up to 17 people with a learning disability and a sensory or physical disability.

There was 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.

We undertook this focused inspection on 4 January 2017 to check that they had followed their plan and to confirm that they now met legal requirements in relation to breaches of regulations 15 and 19. We also looked into concerns we had received in relation to infection control systems and food safety. This report only covers our findings in relation to these issues. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Granleys on our website at www.cqc.org.uk”

At the last inspection, the service was rated Requires Improvement. The rating was displayed incorrectly in the home. The website had not displayed the rating for the home. The website was taken down on 5 January 2017.

At the unannounced comprehensive inspection of this service on 27 September 2016 breaches of legal requirements were found. After this comprehensive inspection, we asked the provider to take action to make improvements to:

• recruitment checks for new members of staff and we found these improvements had been met,

• Infection and control systems within the home; these actions needed further improvement.

The Department of Health’s guidance on the prevention and control of infection in care homes had not being followed. A cleaning schedule was not in place providing clear guidance about the standard expected to maintain the cleanliness of the environment, equipment and fixtures and fittings. An annual statement had not been produced to summarise infection prevention and control measures in the home. Poor practice continued such as placing soiled laundry bags on the laundry floor and rubbish bins without lids.

Some improvements had been made in response to issues raised such as a shower room being refurbished, people’s rooms and bathrooms being cleaned daily and improved standards around food safety management. Recruitment checks required by law had been carried out for new staff.

You can see what action we told the provider to take at the back of the full version of the report.

This was an unannounced inspection which took place over two days on the 28 and 29 September 2016. The Granleys provides accommodation and personal care for up to 17 people with a learning disability and a sensory or physical disability. At the time of the inspection there were 16 people living there.

The Granleys has a registered manager who returned from long term planned leave on 26 September 2016. 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. During the absence of the registered manager cover had been provided by a representative of the provider and the deputy manager.

People’s health and wellbeing was potentially being put at risk due to poor infection control procedures. The cleanliness of the laundry, a shower room, toilet and en-suite toilet had not been maintained. Other issues also needed addressing such as cobwebs, sticky door handles and bins without lids. Recruitment and selection procedures were not as robust as they could have been. Not all of the recruitment checks needed had been completed. People’s care records had not been maintained consistently with discrepancies between care plans and risk assessments. People’s care and support with respect to their age and disability was not always promoted. Some activities were not age appropriate and staff were heard talking to people as though they were children.

People said they liked living at the home and were happy with the service they received. There were systems in place to keep them safe from harm. Accidents and incidents had been recorded and followed up. Staff worked closely with health care professionals to follow up any changes in people’s needs. People were supported to stay healthy and well through their diet and access to health appointments. People enjoyed activities in their local community, using the library, church and leisure facilities. They were encouraged to be independent helping out around their home, cleaning, cooking and shopping.

People had positive relationships with staff who treated them with kindness and care. Staff understood their needs and raised concerns about their health and wellbeing. People’s medicines were administered safely. Staff had access to training and refresher training had been booked. They had individual support meetings with management and found them to be open, accessible and approachable. There were enough staff to meet people’s needs with some flexibility to adjust numbers according to people’s commitments.

People and staff were able to speak with the registered manager about any concerns or issues. Quality assurance systems were progressing and starting to provide evidence of improvements being made to the service. A complaints process was in place. The registered manager addressed some issues we raised with them during the inspection and was keen to drive through improvements to the quality of care provided.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 4 and 5 May 2016 and was unannounced. The Granleys provides accommodation for up to 17 people with a learning disability. At the time of our inspection there were 17 people living there. People had a range of support needs including help with their personal care, moving about and assistance if they became anxious. Staff support was provided at the home at all times and people required supervision by a member of staff when away from the home. Each person had their own room; they shared a bathroom and shower rooms as well as living and dining areas. The home was surrounded by gardens which were accessible to people.

We carried out an unannounced comprehensive inspection of this service on 23 September 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection on 4 and 5 May 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Granleys on our website at www.cqc.org.uk”

At the time of our inspection the registered manager was on long term leave. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The deputy manager had been promoted to cover the registered manager in her absence.

At the inspection on 23 September 2016, we asked the provider to take action to make improvements to:

• records evidencing people’s capacity to consent to the care and support

• the quality assurance systems,

These actions still needed further improvement. You can see what action we told the provider to take at the back of the full version of the report.

At the inspection on 23 September 2016, we also asked the provider to take action to make improvements to:

• safeguarding

• applications for deprivation of liberty safeguards

• staffing levels

• the recruitment and selection of staff

• notifications to CQC

and these actions had been completed. The provider had submitted an action plan and said all improvements would be in place by January 2016.

People were supported by enough staff, who had been through a satisfactory recruitment process. Staff told us there were sufficient staff to flexibly meet people’s changing needs. Staff had access to an induction programme and training had been scheduled. People appeared happy and engaged with staff. Applications had been submitted for people being deprived of their liberty. Risks to people had been monitored and action taken to minimise the risk of harm or abuse. The relevant authorities had been notified about accidents or allegations of harm. People had the opportunity to talk about concerns and complaints at house meetings. There were systems in place to monitor and maintain the environment of the home.

We carried out an unannounced comprehensive inspection of this service on 23 and 24 September 2015 at which a breach of legal requirements was found. This was because the registered person had not protected people against the risks of injury or harm. People’s medicines had not been administered safely.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We undertook a focused inspection on 10 December 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘The Granleys’ on our website at www.cqc.org.uk.

The Granleys had a registered manager. 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 and associated Regulations about how the service is run.

At our unannounced focused inspection on 10 December 2015 we found the provider had followed the action plan which they had told us would be completed by 30 November 2015 and legal requirements had been met.

The Granleys provides accommodation for up to 17 people with a learning disability. At the time of our inspection there were 17 people living there. People had a range of support needs including help with their personal care, moving about and assistance if they became anxious. Staff support was provided at the home at all times and people required supervision by a member of staff when away from the home. Each person had their own bedroom. They shared a bathroom and shower rooms as well as living and dining areas. The home was surrounded by gardens which were accessible to people.

People were protected against the risks of harm or injury. Action had been taken to prevent further accidents and incidents to people. Referrals to health care professionals had been followed up and their recommendations followed. Medicines were being administered safely and in line with national guidance.

We observed the 17 people being supported throughout the day and found that people were encouraged to make choices and decisions regarding activities and what to eat and drink. People were supported in line with their care plans to make these decisions.

People's needs were assessed and plans drawn up to meet their needs. People told us about activities they engaged in. One person told us "I have learnt to go out on my own safely".

We found that all staff had been trained in safeguarding and the staff we spoke were able to tell us what they would do if abuse was suspected, witnessed or alleged.

The provider ensured there was sufficient staffing to meet people's needs. We found that staff were appropriately skilled and experienced. People told us "the staff are very nice, very caring" and another said "they're their to help us when we need it". Throughout the day we observed staff supporting people with sensitivity and in a caring manner that was consistent with people's care plans.

We found the provider asked people's views on the service they received, along with also asking family representatives and staff and that these views were listened to and acted upon. We also saw that complaints and concerns were listened to and appropriate changes made as a result.

During our visit to the home we spoke with eight people who lived at the service. We were able to observe other people spending time in the communal areas. On the day of the visit people were engaged in a variety of activities which included going out for a pub lunch in the local area. Some people we met were doing art work, completing jigsaws or watching the television.

Everyone we spoke to said they were happy living in the home, liked their rooms and enjoyed the activities they were able to access. One person told us that they enjoyed going out and that the staff really encouraged people to participate in activities.

Interviews for new staff were taking place during the visit and a person who used the service said that it was great to be able to have a say as to who will offer support in the future.

Staff we spoke with and observed showed that they had a good knowledge of the people they supported. They were seen responding to each person respectfully, with good humour and in a manner appropriate to each individuals needs. The home regularly asked people who used the service, their representatives and other professionals their views about the care and support the home provided. When feedback was given the home acted upon it and used these comments to improve the service.

This was an unannounced inspection which took place over two days on the 16 and 22 August 2017. The Granleys provides accommodation and personal care for up to 17 people with a learning disability and a sensory or physical disability. At the time of the inspection there were 16 people living there.

The Granleys has a registered manager who was absent during our inspection. A representative of the provider was present. 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.

At the last comprehensive inspection, the service was rated as requires improvement. At this inspection we found the service was good and the service had made improvements to infection control systems and recruitment processes. They had also made improvements to the care planning processes and people were being treated with dignity and respect.

Quality assurance systems were in place to monitor the quality of care people received and to identify any shortfalls in the service. However, some improvement was needed to ensure all aspects of the service would be audited so that action would be taken to address these issues promptly. The representative of the provider took action during the inspection to ensure the appropriate pre-employment checks would be completed as part of their recruitment processes. They also made sure checks for fire systems and water temperatures were being carried out at the appropriate intervals. Quality assurance systems included feedback from people living in the home, their relatives and staff. Improvements made over the past 12 months to the environment, infection control systems, care records and staff support had been maintained.

People were supported by sufficient staff to meet their needs. Staff had access to training to acquire the skills and knowledge to support people. They had individual and group support to reflect on their roles and professional development. Staff had a good understanding of people’s needs and treated them respectfully and with kindness.

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 support this practice. People’s care was individualised reflecting their individual needs, preferences and lifestyle choices. Their care was discussed with them and their care records were kept up to date with their changing needs. People were supported to stay healthy and well through access to health care professionals and a healthy diet.

People’s rights were protected and they were kept safe from the risk of injury or harm. Any accidents or incidents were analysed and the appropriate action was taken to prevent them happening again. People who became anxious or upset were supported to manage their emotions. People’s medicines were administered at times to suit them. Medicines systems were monitored closely to ensure they were managed safely. People had access to a range of activities which were meaningful and reflected their choice and interests. They were actively involved with their local community using places of worship, the library, sports facilities and shops.

The registered manager and the representative of the provider were open and accessible. People and staff were confident talking with them about any issues or concerns. People knew how to raise concerns and complaints information was accessible to them. The management team were aware of the challenges of recruiting and keeping staff. The staff team spoke positively about their support and the care they provided.