Background to this inspection
Updated
20 January 2021
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 Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. 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 carried out by two inspectors, an assistant inspector and a medicines inspector.
Service and service type
Christopher Grange 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 had a manager registered with the Care Quality Commission. This means that they and the provider are 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 on the first day and announced on the second day.
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 all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report .
During the inspection
We spoke with eight people who used the service about their experience of the care provided. We also spoke with the registered manager of the service and six members of care staff.
We reviewed a range of records. This included six people's care records and multiple medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, were reviewed.
After the inspection
Due to the risks of coronavirus, we reviewed paperwork remotely where possible. We spoke with three members of care staff by telephone. We also spoke with five relatives to obtain feedback about the care and support received by their family member. We continued to seek clarification from the provider to validate evidence found. We spoke with the local authority to keep them informed of our inspection findings.
Updated
20 January 2021
About the service
Christopher Grange is a residential care home providing personal care to 53 people aged 65 and over at the time of the inspection, including people living with dementia. The service can support up to 78 people and is comprised of four units.
People's experience of using this service and what we found
People told us that they were happy with the care and support provided by staff. However, the home did not always suitably manage risk to people.
Medicines were not always managed safely. Some environmental checks were either not in place or had not identified the concerns found at our inspection. People were exposed to a risk of harm.
The service was not always well managed. Practices across the different units were inconsistent. Assurance and auditing processes did not always adequately mitigate risk to the health and welfare of people living at the service.
The registered manager began to address our findings following the inspection, showing they were responsive to making the required improvements, and that the safety and quality of the service was a priority.
People's relatives spoke positively about the care and support their family member received. There were enough staff to meet people's care and support needs.
Staff told us they enjoyed their job and felt supported in their role.
The service appeared well maintained and clean and staff followed effective infection prevention and control measures.
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 (published 12 June 2019).
Why we inspected
The inspection was prompted in part by notification of a specific incident, following which a person using the service died. This incident is subject to a criminal investigation and also involves other health care providers. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of medicines. This inspection examined those risks.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at 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 Christopher Grange Care Home on our website at www.cqc.org.uk.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.