The inspection took place on 18 September 2018 and was unannounced. The last inspection took place in November 2015, when the service was rated overall Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Wood Hill Grange Care Home’ on our website at www.cqc.org.uk.

Wood Hill Grange Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Wood Hill Grange Care Home provides accommodation for up to 75 people. The home consists of four separate units, one providing accommodation and personal care and the other three providing nursing care. Some people receiving support at the home were living with dementia. The home is in Sheffield. At the time of our inspection there were 54 people using the service. This included some people who were staying at the home following a hospital stay but were not well enough to return home.

At the time of our inspection there was no registered manager employed at the home. 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. The registered provider had appointed a manager who was in the process of registering with the Care Quality Commission and was employed at the home.

The registered provider had systems in place to ensure people were protected from the risks of abuse. One incident was reported to the head of care during our inspection and appropriate actions were taken when the head of care had been alerted.

Risks associated with people’s care were identified. However, some risks were not always managed in a safe way.

We completed a tour of the home with the manager and found that some areas of the service were not maintained in a clean state. We brought these concerns to the attention of the manager who acted on the day of our inspection to address the issues raised.

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. However, information regarding people’s best interest decisions had not always been documented.

People received a healthy, balanced diet which met their needs and took in to consideration their preferences.

Staff received training and support to carry out their role. Staff we spoke with told us they received regular training. However, they told us that supervision sessions were not taking place regularly, but they felt supported by the management team.

We observed staff interacting with people who used the service and saw they were kind and caring. We observed staff maintaining people’s privacy and dignity.

The registered provider had a system in place to monitor the service. A range of audits were in place and most of them identified areas of improvement and these were addressed in a timely manner. However, we found the audits in relation to medicine management and infection control were not effective as they had not identified the concerns we raised during our inspection.

People, their relatives and staff were asked for their view regarding the service. We spoke with the manager who informed us that feedback from questionnaires was not displayed in the home. The manager told us they would look at ways they could make this more accessible to people who used the service and their relatives.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to Regulation 12 safe care and treatment and Regulation 17 good governance. You can see w

We carried out an unannounced comprehensive inspection of this home on 23 and 24 March 2015 where breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breach of Regulation 12(1) including Regulation 12(2)(f) and (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection on 21 September 2015 to check that they had followed their plan and to confirm that they now met the 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 Wood Hill Grange Care Home on our website at www.cqc.org.uk.

Wood Hill Grange Care Home is located in north east Sheffield. The home has a secure landscaped garden and car park. Wood Hill Grange Care Home provides accommodation for up to 73 older people over four floors accessed by two lifts. The home has 19 rooms on the ground, first and second floor and 17 rooms on the third (top) floor. Each room has an en-suite shower room. There are two lounge/dining areas on each floor of the home.

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. The registered manager was present on the day of our inspection.

We found the home had improved their policies, procedures and practice regarding the safe management and administration of medicines. Medicines at the home were appropriately stored, with temperature control mechanisms in place. Medication Administration Records (MAR) demonstrated the home administered medicines as instructed by the prescribing healthcare professional.

Controlled drugs are prescription medicines, which are controlled under the Misuse of Drugs legislation. Controlled drugs were stored correctly and the controlled drugs register was maintained.

We could not improve the ratings from ‘Requires Improvement’ because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

We used both formal and informal observation throughout our inspection at Wood Hill Grange in order to gain information for this outcome area. This was because some people living at the service had dementia and were not able to tell us about their experience of living at the home. The formal assessment we used is called the ‘Short Observational Framework for Inspection (SOFI). In order to capture the experience of these people we sat and undertook a SOFI observation on Lady Bower, the unit which supports people who have dementia and / or complex needs. These observations enabled us to see how staff interacted with people and see how care was provided.

Our SOFI and other observations throughout the day of our inspection showed us that staff treated people with dignity and respect. We saw that staff clearly knew people, offered choices and knew people’s preferences and the importance of these for people.

We spoke directly about care, treatment and support with eight people who used the service. One person who used the service stated, “I couldn’t wish for a better place, I get my tablets on time and the care is excellent.”

Another person who used the service told us that the food within the home was, “champion” and stated, “there’s always two choices and there’s nothing I’ve disliked yet.” The same person was also positive about cleanliness within the home. They told us, “I’ve been in a number of care homes and this is the cleanest I’ve been in. They clean my room every day and even clean on top of the wardrobe!”

We spoke with three relatives about the care their family received at the home. Each relative told us that they were confident in the way in which their relative was cared for. They also told us that they were informed straight away of any issues about their relative’s care.

People told us that they felt safe living at the home. Relatives also felt that their family members were safe living at the home. One relative said, “knowing [my relative] is safe here means I sleep better. I wouldn’t sleep if I didn’t think [my relative] was safe here”.

We spoke to people and their relatives about staffing at Wood Hill Grange. One person said, “the staff are great and can’t do enough for you”. The same person stated that staff within the home, “work as a team.” Another person stated, “the staff here are spot-on, they do all they can”. Another person stated, “it’s a home, real home, all the staff are great. If you have a problem they will all help you.”

Relatives were also positive about the staff, management and owner of the home. One relative described the owner of the home as, “absolutely brilliant”, and told us that both the owner and the manager were visible and approachable.

We carried out this inspection on 23 and 24 March 2015 and it was unannounced.

Our last inspection of the service took place on 30 April 2013 and 01 May 2013 and we found the service was meeting the requirements of the regulations we inspected at the time.

Wood Hill Grange Care Home is located in north east Sheffield. The home has a secure landscaped garden and car park. Wood Hill Grange Care Home provides accommodation for up to 73 older people over four floors accessed by two lifts. The home has 19 rooms on the ground, first and second floor and 17 rooms on the third (top) floor. Each room has an en-suite shower room. There are two lounge /dining areas on each floor of the home. On the day of our inspection, there were 71 people living at the home.

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. The registered manager was present on both days of our inspection.

The service ensured people were protected from abuse and followed adequate and effective safeguarding procedures. We found care records were personalised but could be improved with more information for staff to provide person-centred care and support.

We found good practice in relation to decision making processes at the home and in line with the Mental Capacity Act 2005 (MCA) Code of Practice, with the principles of the MCA and Deprivation of Liberty Safeguards being followed.

There were issues around medicines at the home, where some medicines being used were out of date or had been dispensed incorrectly by the pharmacist.

There were good quality-monitoring systems in place at the home that were carried out on a monthly basis. We saw that, where issues had been resolved, action plans needed updating to reflect this.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which is now replaced by 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.