The Grange Residential Care Home

Updated 25 November 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector, an inspection manager, a Specialist Advisor (nurse) and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Grange Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Grange Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 11 May 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service and seven relatives about their experience of care provided. We spoke with eight staff, including housekeeping and care staff, the deputy manager, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included three people's care records and multiple medicine records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 25 November 2022

About the service

The Grange Residential Care Home is a residential care home providing accommodation for people requiring personal care to up to 36 people. The service provides support to younger adults and older people, people living with dementia, people with a sensory impairment and people with a physical disability. At the time of our inspection there were 36 people using the service. The accommodation contains several communal areas on the ground floor and has bedrooms, bathrooms and toilets on both floors.

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

We found people were at risk of harm as fire safety risks and risks associated with substances posing a hazard to health had not always been identified. Infection prevention and control measures (IPC) were not consistent in the home to keep people safe from the risk of cross infection.

Systems to identify improvements in the home were not implemented effectively. Audits carried out by the manager and provider did not identify the fire safety and IPC issues we identified.

People felt safe in the home and they, or their relatives, knew how to raise any issues they might have. There were sufficient staff deployed to meet people’s needs. Medicines were managed safely, and people received their medicines as prescribed.

People’s needs were assessed, and their care planned in line with current good practice guidelines. People were referred for professional assessment and care when needed. People were cared for by competent staff.

People were supported by staff who were kind and knew them well. Staff understood and respected people’s individual preferences.

People, or their relative where appropriate, were involved in their own care. Care plans were person centred, including details of people’s sensory and communication needs. People, or their relative, felt confident any complaints they may have would be dealt with.

People believed the service was well led and gave positive feedback about the registered manager and staff team. The overall aim of the service was for people and their families to be happy. This outcome was worked towards by the care staff to achieve this for the people who lived there. Staff felt well supported in their role.

Mental Capacity Act

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 20 January 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed. We have identified breaches in relation to the identification and safe management of fire safety risks, the control of substances hazardous to health and infection prevention and control 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.