The Grange

Updated 3 March 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.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector. An Expert by Experience completed telephone calls to people’s relatives on 4 February 2022. 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 is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission but an application had been submitted. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

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 reviewed information we had received about the service since it was registered. We used this information to plan our inspection.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with three members of staff, the staff member responsible for facilitating social activities, the staff member responsible for Human Resources [HR], the manager, the area manager and the service’s Infection Control Lead. We reviewed seven people’s care files and three staff personnel files. We looked at the service’s quality assurance arrangements, the provider’s arrangements for managing medication, staff training and supervision data, complaint and compliment records.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the manager to validate evidence found. We continued to look at the service’s quality assurance arrangements, spoke with six members of staff and four people living at The Grange.

Updated 3 March 2022

About the service

The Grange is a residential care home providing the regulated activity of personal and nursing care for up to 40 people. The service provides support to older people, including people who are living with dementia in one adapted building and across two floors [Audley and Saffron Suites]. At the time of our inspection there were 37 people using the service and this included three people who were in hospital.

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

We could not be assured staffing levels were always suitable to meet people’s needs. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. Risks to people’s safety and wellbeing were assessed, recorded and followed by staff. Recruitment practices at the service were safe. Suitable arrangements were in place to ensure people received their medication, but improvements were required to ensure the service’s controlled drug book was accurate. People were protected by the prevention and control of infection. Lessons were being learned and improvements made when things went wrong.

Suitable arrangements were in place to ensure staff were appropriately trained and newly appointed staff received an induction. However, improvements were required to make sure all staff received ‘move and assist’ training. Staff felt valued and supported and received formal supervision. The dining experience for people using the service was good. People received enough food and drink to meet their needs. People were supported to access healthcare services and receive ongoing healthcare support as needed. 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.

People and those acting on their behalf told us they were treated with care, kindness, respect and dignity. Staff had a good rapport and relationship with the people they supported, and observations demonstrated what people told us.

People’s care and support needs were documented, and staff had a good understanding and knowledge of these and the care to be delivered. Suitable arrangements were in place to enable people to participate in social activities Monday to Friday. People were confident any concerns raised would be listened to and acted upon.

People told us the service was well-led and managed. Quality assurance arrangements enabled the provider to monitor the quality of the service provided.

We have made a recommendation about staffing levels.

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

Rating at last inspection

This service was registered with us in April 2021 and this is the first inspection.

Why we inspected

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

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.