Gracewell of Chingford is a care home for 46 older people, some of whom may be living with dementia. 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. The home is spread out over three floors. At the time of this inspection there were 45 people using the service.

This care home is run by two companies: Gracewell Healthcare Limited and Bayfield Court Operations Limited. These two companies have dual registration and are jointly responsible for the services at the home.

This inspection took place on 17, 21 and 24 December 2018. The inspection was unannounced. At the last inspection in October 2016, the service was rated as Good. This inspection was prompted by an increase in incidents being reported. At this inspection we found the service had met all relevant fundamental standards and remained Good.

The service had a registered manager. 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.

Staff were knowledgeable about reporting abuse and whistleblowing. There were enough staff on duty to meet people’s needs. The provider had safe recruitment procedures in place. Risk assessments were carried out to mitigate the risks of harm people may face. Building and equipment safety checks were carried out. Medicines were managed safely. People were protected from the risks associated with the spread of infection. Accidents and incidents were recorded, and lessons learnt from these.

People had their care needs assessed before they began to use the service. Staff were supported to carry out their role effectively through supervisions, appraisals and training. People were offered choices of nutritious food and drink and staff were knowledgeable about people's dietary requirements. Staff assisted people to maintain their health. The provider had systems in place for the staff team to share information about people’s well-being. The building was tastefully decorated. However, the décor of the building meant some people could have difficulty finding their bedroom. The provider was in the process of refurbishing the building. Care was provided in line with the requirements of the Mental Capacity Act (2005). Staff understood the need to obtain consent before delivering care.

People and relatives thought staff were kind and caring. Staff explained how they got to know people and their care needs. People and their relatives were involved in decisions about the care. Each person had a named care worker who had overall responsibility for their care. Staff knew how to provide an equitable service. People’s privacy, dignity and independence were promoted.

Staff understood how to provide a personalised care service. Care plans were personalised, contained people’s preferences and were reviewed monthly. People were offered a variety of activities to meet their social needs. Care plans included people’s communication needs. The provider kept a record of complaints and these were used to make improvements to the service. People had their wishes documented for end of life care.

People, relatives and staff gave positive feedback about the leadership in the service. The provider had a system in place to receive feedback about the service from people using the service, relatives and staff so they could use these to make improvements to the service. People, relatives and staff had regular meetings, so they could be updated and give their views about the development of the service. The provider had quality audit systems in place to identify areas for improvement. The service worked in partnersh

There are two registered providers for this service who are registered separately with the Care Quality Commission (Gracewell Healthcare Limited and Bayfield Court Operations Limited). The service is known both as Gracewell of Chingford and Bayfield Court and this report can be found under each location name. This service is a residential care home which provides personal care for up 46 older people some of whom may be living with dementia. The home is spread out over three floors. At the time of this inspection there were 44 people using the service.

The manager in post at the time of our inspection was in the process of applying to become registered with the Care Quality Commission. 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.

Staff knew how to report concerns or abuse. There were enough staff on duty to meet people's needs who were employed through safe recruitment processes. Risk assessments were carried out and management plans put in place to enable people to receive safe care. There were effective and up to date systems to check and maintain the safety of the premises. Medicines were administered and managed safely.

Staff received support through supervisions and training opportunities. Appropriate applications for Deprivation of Liberty Safeguards had been applied for and authorised. Staff obtained consent when carrying out care tasks. People were offered a varied and nutritious food menu and staff were knowledgeable about their dietary requirements. Healthcare professionals gave positive feedback about their joint working with the service. Records showed people had access to healthcare professionals as required to meet their day-to-day health needs.

People thought staff were caring and staff knew how to build positive relationships with people who used the service. Each person had a named carer who oversaw the care they received. Staff ensured people’s privacy and dignity was respected and their level of independence was maintained. There was a calm and happy atmosphere throughout the home.

Care plans were written in a personalised way. Staff knew the people they were supporting including their preferences which helped ensure a personalised service was provided. A variety of activities were offered including visiting entertainers, a bistro service onsite and trips out to events in the community. The service dealt with complaints in accordance with their policy and timescales.

The provider was trying out holding separate meetings for people who used the service and for relatives but was considering returning to the previous system of holding them jointly. People and their representatives were given the opportunity to complete feedback surveys. The provider had quality assurance systems in place to identify areas for improvement.