We carried out a review of the data available to us about The Grange on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Grange, you can give feedback on this service.
The Grange accommodates up to 74 people with residential care needs in a purpose-built building. 59 people were using the service at the time of the inspection.
People’s experience of using this service and what we found
People were protected from risks. Monitoring of health and safety procedures and equipment was in place and these systems were well embedded. There were enough staff on duty to meet people’s needs. Appropriate arrangements were in place for the safe administration and recording of medicines. Infection prevention and control procedures were in place to reduce the risk of infection and to keep people safe.
The provider and registered manager monitored the quality of the service to make sure they delivered a high standard of care. Professionals we spoke with said the services communicated with them well and they received clear information from staff about people's wellbeing.
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 12 May 2020) and there was one breach of regulation. 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 improvement had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a focused inspection base don risk. We carried out an unannounced inspection of this service on 5 and 6 December 2019. One breach of legislation relating to safe care was found. The provider had failed to take steps to minimise the risk of legionella at the service. On this visit we found the service had made improvements and now met all required regulations.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 on our website at www.cqc.org.uk.
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.
The Grange is a residential care home providing personal care for up to 74 people. At the time of our inspection there were 66 people living at the home. Accommodation is provided over two floors.
People’s experience of using this service and what we found
The service did not have a robust system in place to manage the risk of legionella in the water supply. There was no legionella risk assessment and regular checks on the water supply to minimise the risk of legionella bacteria had not been carried out consistently. Legionella bacteria can cause legionnaire's disease, a type of pneumonia.
Audits were in place to monitor the quality of the service and the environment. However, the auditing system had failed to identify inadequate legionella management.
The environment was clean, well-maintained and attractively decorated. Good infection control practices were followed. People had access to a good standard of equipment where needed. Servicing of equipment had been carried out.
People were looked after by staff who were kind and caring. One relative told us," I couldn’t speak too highly of them. The staff are marvellous.”
People were cared for by staff who knew how to keep them safe. There were systems in place to ensure only staff who were suitable to work with vulnerable people were recruited. Staff had completed appropriate training and received regular supervision to help develop their skills and support them in their role. There were enough staff to provide the appropriate level of support to people.
The requirements of the Mental Capacity Act 2005 were being met. 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.
Medicines were administered safely and as prescribed. Risks associated with people's needs had been assessed, were understood and managed by staff, which meant people were safe from harm.
People were supported to eat a well-balanced diet and were offered a variety of meals and snacks. People’s healthcare needs were being met. The home referred people appropriately to healthcare professionals when any issues or concerns had been noted, such as unplanned weight loss.
People’s social and recreational needs were met through a varied activities programme, which included regular access to the local community.
Relatives and staff were complimentary about the way the home was managed.
Team meetings were held regularly to pass on key information and involve staff in the running of the home.
Recently implemented electronic care records contained detailed information about how each person wished to be supported. The registered manager was aware that further work was needed to ensure that all the information recorded was accurate.
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 (report published 29 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
At this inspection we identified a breach of the regulations in relation to the prevention of legionella in the home's water supply.
Please see the action we have told the provider to take at the end of this report.
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.
The inspection took place on 24 May 2017. The inspection was unannounced.
The Grange care home is a residential care home based in Darlington, County Durham. The home provides personal care for older people and people with dementia. It is situated close to the local amenities and transport links. The home is registered for up to 74 people and on the day of our inspection there were 68 people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The service had not been rated under the new registered provider of Burlington Care Limited so this was a first rated inspection for The Grange Care Home.
The atmosphere of the service was homely and very welcoming.
People who used the service and their relatives that we spoke with told us they were satisfied with the service.
We saw staff interacting with people in a caring and attentive way.
We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness.
We saw that people were encouraged to enhance their wellbeing and take part in activities.
We spoke with a range of different team members; care, kitchen staff and activity staff, who told us they all felt well supported and that the registered manager was supportive, and they were all polite, receptive, open and approachable. We also spoke with visiting professionals from the community nursing team.
Throughout the day we saw that people who used the service, relatives and staff were comfortable, relaxed and had a positive rapport with the registered manager and also with each other.
From looking at people’s care plans we saw they were written in plain English and in a person centred way. They also included a ‘life map’ that made use of personal history and the plans described individuals care, treatment and support needs.
Care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm.
People’s health was monitored and referrals were made to other health care professionals where necessary, for example their GP, community nurse or dentist.
People who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.
Staff had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs.
Robust recruitment processes were in place.
We observed how the service administered medicines and how they did this safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and we found that the process was safe.
People were encouraged to eat and drink sufficient amounts to meet their needs. Drinks were out for people and we observed people being offered a varied selection of drinks and snacks.
People and their relatives were knowledgeable about the complaints and compliments procedure that was in place.
People also had their rights respected and access to advocacy services if needed.
The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found.
People who used the service and their representatives were regularly asked for their views about the care and service they received at meetings and via surveys. Views were then taken on board using a ‘you said we did’ system.