15 June 2023
During an inspection looking at part of the service
The Grange – Care Home Physical Disabilities is a residential care home providing personal care to 24 people at the time of the inspection. The service can support up to 27 people.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
People had their risks assessed but actions to minimise avoidable harm were not being monitored or reviewed. This included risks associated with malnutrition, dehydration, and fire safety. Quality assurance systems were not robust enough to ensure people were receiving the right care.
People were supported by staff that had undertaken a robust recruitment process. Medicines were administered safely, and infection, prevention and control measures were in line with best practice guidance. People felt safe and felt able to raise any concerns with staff knowing they would be listened to and appropriate actions taken.
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; the policies and systems in the service supported this practice.
Right Care:
People lived in an environment that had been designed to support their independence. People were supported by staff that had the right skills and experience to meet their care and support needs. People were involved in decisions about their care and supported by staff that knew them well and respected their lifestyle choices. Staff understood the importance of social inclusion and supported people to keep in touch with friends and family and develop and maintain links in the community.
Right Culture:
People felt confident in speaking up and sharing their views with the management and staff team. Through regular meetings and quality surveys people were empowered to contribute to the development of the service. People had their communication needs understood which meant that information could be shared in a format that ensured inclusion.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 April 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Grange – Care Home Physical Disabilities on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.