The Grange

Updated 24 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke with seven members of staff including the provider, registered manager, office manager, care workers and the chef. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We sought clarification relating to systems in place for monitoring of the safety of the service.

Updated 24 December 2019

About the service

The Grange is a residential care home providing personal and nursing care to 30 people aged 65 and over at the time of the inspection. The Grange accommodates up to 35 people in one adapted building.

People’s experience of using this service and what we found

People felt safe living at The Grange. Risks to people were identified and managed. Records relating to risks were not always complete. They were supported by staff who knew how to identify and report any concerns relating to harm and abuse. People received their medicines as prescribed. There were sufficient staff to ensure people’s needs were met.

The service ensured people received food and drink to meet their dietary needs. Staff felt supported and completed training to ensure they had the skills and knowledge to meet people’s needs. People were supported to access health professional support to enable them to live healthier lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; there were policies and systems in the service that supported this practice. However, records were not always consistent relating to people’s capacity and we have made a recommendation in relation to this.

The atmosphere within the service was friendly and welcoming. Staff were caring and ensured people were treated with dignity and their rights respected. People were involved in their care and staff promoted independence. People’s privacy was respected, and records were stored securely.

People and their families had positive and caring relationships with staff. People enjoyed a range of activities which included visits from community groups. Complaints were investigated and responded to in line with the provider’s policy. People’s end of life wishes were recorded and staff worked with professionals to ensure people had dignified end of life care.

There were some systems in place to monitor and improve the quality of the service. The systems were not always effective. There was an open culture that encouraged the involvement of everyone and promoted a person-centred culture. Staff felt valued and listened to.

Rating at last inspection

The last rating for this service was good (published 18 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.