10 October 2023
During an inspection looking at part of the service
The Grange Retirement Home is a residential care home providing personal and nursing care up to 62 people. The service provides support to adults, including adults living with dementia. At the time of our inspection there were 60 people using the service. The care home supports up to 60 people in an adapted building over 3 floors.
People’s experience of using this service and what we found
People were not always kept safe from the risk of harm. Some people’s care plans had contradicting information throughout about what their risks were and contained insufficient guidance for staff on how to manage them. Some staff were not always aware of individual risks of the people they were supporting.
The management of medicine was not always safe and in line with guidance that should be followed by a nursing home.
Risk to the environment was not always managed well. For example, the fire log to ensure all people were accounted for in the building was not always completed by the staff on duty.
Audits had not always identified the concerns we found during the inspection. There were elements of the governance within the home which was not always effective to ensure full oversight of the quality of the home and staffing.
Generally 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 relatives in general confirmed they were happy with the care provided and felt safe being supported by the staff.
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 good (published 21 October 2023).
At our last inspection we recommended the provider considered current guidance on recording ‘as and when required’ medicines, when these are given to people and take action to update their overall medicine management practice accordingly. At this inspection we found the provider had not made enough improvement in this area.
Why we inspected
We received concerns in relation to the management of medicines and people’s nursing care needs, safeguarding incidents, fire safety, staff knowledge and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Grange Retirement Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.