This inspection visit took place on 08 November 2016 and was unannounced.

Christopher Grange Residential Care Home provides accommodation and personal care for up to 78 people. It is part of a range of services provided in Liverpool by the Catholic Blind Institute. Car parking facilities are available within the grounds. At the time of the inspection 76 people lived at the home.

At the last inspection on 30 September 2013 the service was meeting the requirements of the regulations that were inspected at that time.

There was a registered manager in place. 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 looked at the recruitment process for staff at Christopher Grange. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed an induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They were encouraged to attend courses to develop their skills and gain professional qualifications. We found staff had the skills, knowledge and experience required to support people who lived at the home. One staff member said, “Training opportunities here are very good.”

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when needed. Staff had received safeguarding training and they confirmed this when we spoke with them.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

We found sufficient staffing levels were deployed in the units to support people. This was confirmed by our observations and people we spoke with. However at times people we spoke with felt staff were ‘very busy’ in one of the units. The registered manager told us they monitored staffing levels and were aware of the issue in one unit. They were in the process of assessing staff in one unit to increase support during the day so that people felt safe and staff were able to provide support people required.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People had access to healthcare professionals and their healthcare needs were met.

People we spoke with were happy with the quality and quantities of meals provided. They also told us there were choices at meal times. During the day we saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The staff confirmed at any time if people required refreshments it was available. One person who lived at the home said about the quality of food, “The food is good you cannot knock it.”

Christopher Grange had its own chapel within the building. A pastoral team of religious sisters lived on the site. They provided support and company for people who wanted pastoral support. Mass was conducted daily and everybody was welcome as well as people from the local community from all religious denominations.

People told us they enjoyed activities and the entertainers organised by the service. Activity coordinators were employed and people who lived at the home were pleased with the regular trips out and entertainment provided. One person who lived at the home said, “Y

People who lived at the home told us: “It is calm with no fuss, everyone is straight-forward.”; “We can have drinks whenever we want them.”; “Everything’s fine here.”; “The staff always do their best.” A member of staff who was fairly new to the home said “I love it here and I’m proud to say that I work at Christopher Grange.”

We looked at a sample of care files for people who lived at the home. The care plans provided staff with information about the care and support people needed in daily living including mobility, personal care, eating and drinking, accessing the community, social interests and communication.

All parts of the home that we visited were clean and well-maintained.

Staff received training in subjects relevant to their work including safeguarding, moving and handling, first aid, fire awareness, health and safety, food hygiene, and infection control. Some staff had also received training about end of life care, dementia awareness, medication, mental capacity, person centred planning and dignity awareness.

We spent time in each of the units and 'The Market Place’ and spoke with fifteen people using the service, seven of their relatives and fourteen staff. We found that people living at the home had been treated with respect and that they and/or their relatives had been involved in the planning and delivery of their care and treatment. Comments made by people using the service and their relatives included, "I love it here”. “I consider this to be my home”. “It couldn’t be better”. I have no complaints”. “All the staff are polite and friendly”. “I can speak up for myself”. “I wouldn’t want my mum to live any where else”. We found that people had had their care needs assessed and that staff had information about how to meet those needs in a way which ensures people's health, safety and welfare. People were being cared for by staff who were well supported and trained. People using the service and their relatives told us they thought the staff were very good at their jobs. Everybody we spoke with told us they had no concerns about the way people had been treated at the home and they told us they were confident that people were safe. They told us they knew how to complain and would do if they needed to.

People who use the service told us that they like living at the home and that they are treated well by all the staff. One person commented, “The staff are very good, they treat me well and are respectful and helpful”. Another person said, “The staff are very attentive and nothing is too much trouble for them”.

People told us that they get the support they need from the staff team and think their care needs are met well at the home. One person said, “I am very satisfied with what I am paying for”.

People told us that they have a care plan which they helped with. People also said they make choices and are encouraged to do things for themselves and are involved in making decisions about the care and support they receive. One person commented, “I go to bed and get up when I choose and I choose the clothes I wear each day”.

People told us that they are provided with equipment and aids to help them with their mobility and comfort.

The people living at Christopher Grange had mixed views regarding whether there were enough staff available to provide support to them. One person told us that they always get the help they need from staff. They explained that at night if they need support they only have to press the call bell and night staff respond quickly. They also told us that during the night staff regularly check they are okay.

Another person told us that staff come quickly when they use their call bell, they commented, “they come quick, very good”. However the person expressed the view that one night staff was not enough to support people although they did not give any examples of when this support was not available.

Another person who was using the service said, “I never feel rushed by staff and they are all attentive and helpful". The person also said, "Staff are very busy most of the time and don’t really get much time to sit down and talk to us".