The Grange

Updated 29 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the http://crmlive/epublicsector_oui_enu/images/oui_icons/cqc-expand-icon.pngregistered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed 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 a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The registered manager was also the sole director of the company who ran the service and who was the registered provider. The registered provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice of the inspection because some of the people living in the service could not consent to an inspector visiting their home. This meant we had to arrange for a ‘best interests’ decision about this.

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 and professionals who work with the service. We used information the registered 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 all the people living in the service using sign-assisted language when necessary.

We spoke with three care staff, the deputy manager and the registered manager.

We reviewed documents and records that described how care had been planned, delivered and evaluated for three people.

We examined documents and records relating to how the service was run. This included health and safety, the management of medicines and staff training and recruitment. We also looked at documents relating to learning lessons when things had gone wrong, obtaining consent and the management of complaints.

We reviewed the systems and processes used by the registered manager to assess, monitor and evaluate the service.

Updated 29 October 2019

About the service

The Grange is a residential care home without nursing for five people who have learning adaptive needs/autism. At the time of this inspection there were five people living in the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who live in a service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning adapative needs and/or autism to live meaningful lives that include control, choice and independence. People living in the service receive planned and coordinated person-centred support that is appropriate and inclusive for them.

People's experience of using the service and what we found

People and their relatives were positive about the service. A person said, “I like the staff and they’re nice.” Another person smiled and pointed in the direction of their bedroom when we used signed-assisted language to ask them about their home. A relative said, "I think The Grange is excellent. It’s not posh but they completely understand my family member.”

The outcomes for people living in the service reflected the principles and values of Registering The Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become as independent as possible.

People were safeguarded from the risk of abuse. People received safe care and treatment in line with national guidance from care staff who had the knowledge and skills they needed. There were enough care staff on duty and safe recruitment practices were in place. People were supported to take medicines safely and lessons had been learned when things had gone wrong. Good standards of hygiene were maintained and people had been helped to quickly receive medical attention when necessary.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

The accommodation met people's needs, people’s privacy was respected and confidential information was kept private.

People were consulted about their care, given information in an accessible way and supported to pursue their hobbies and interests. There were arrangements to quickly resolve complaints and people were treated with compassion at the end of their lives so they had a dignified death.

Quality checks were completed and people had been consulted about the development of the service. There was good team-work, regulatory requirements had been met and joint working was promoted.

For more details, please read 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 at our inspection (published 11 October 2018) and there was one breach of regulations. 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 improvements had been made and the provider was no longer in breach of regulations.

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.