Archived: The Grange

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe? People were treated with respect and dignity by the staff. People told us they felt safe.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and appropriate applications had been submitted and records held accordingly. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people will be safeguarded as required.

Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw that people had been involved in writing them and they reflected their current needs.

Visitors confirmed that they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People using the service, their relatives, friends and other professionals involved with the service were asked for their views through meetings and surveys. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The new activity staff member was developing links in the local community so people could access this more.

People knew how to make a complaint if they were unhappy. We looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely and any learning points addressed. People can therefore be assured that complaints are investigated and action is taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We saw people were encouraged to make their own decisions about their care where they had the ability to do this. We saw people's everyday choices were respected, such as where and when to dine and how to spend their day. People and their relatives described staff as 'friendly, helpful and caring'.

We found care records had enough information so staff would be able to know how to support individual people in the right way.

We found the home had improved the medication records and systems to make sure people's medication was now managed in a safe way.

People told us the accommodation was comfortable and we saw the home was clean, warm and well maintained. There had been some improvement to signage and special decor to help people with dementia to find their way around by themselves.

We found the provider carried out checks to make sure that only suitable staff were employed. The provider carried out regular checks of the quality of the service and identified any areas for improvement.

During this visit we looked at the medicines records and supplies for eight people. We found people were not always receiving their medicines correctly. Some medicine records were not fully completed, and the guidance about some people 'when required' medication was not always available. Eye drops for two people were found to be in use for several days past the recommended expiry date once opened.

We saw the staffing levels had improved and we were told that more staff were to start work at the home in the near future. We saw there were sufficient staff around the home to respond promptly when people requested support.

We spoke with four people and a visitor during this visit. People told us the staff were 'kind' and 'helpful'. One person said, 'The girls are very nice, if I need anything they come.' Another person told us, 'I don't have to wait too long, I just give them a shout.'

One person told us, 'Everything is very nice, although sometimes I have to wait for a second member of staff when I need the toilet. When I buzz one staff will come, but then they have to find another staff as well.'

We found care records had enough information so staff would be able to know how to support individual people in the right way. Staff had a good knowledge of people's needs. People told us they were 'comfortable' and 'safe' at this home. All the people we spoke with felt confident about making any comments or raising concerns with management staff.

We found the home's medication records and systems were not always making sure that people got their medication in the right doses.

People told us they were satisfied with their accommodation. We saw the home was bright, comfortable and well maintained. However it did not have good signage or special decor to help people with dementia to find their way around by themselves.

People told us they often had to wait long periods for staff to come when they had called for assistance. A visitor told us, 'The staff are lovely but they're rushed off their feet downstairs.' There were not enough staff on the ground floor to always meet people's needs in a timely way.