Carpathia Grange

Updated 20 July 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 team consisted of two inspectors, a medicines inspector, an assistant inspector, a nurse specialist and an Expert by Experience provided off site support. 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

Carpathia 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 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.

What we did before the inspection

We reviewed information we had received about the service. 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.

We used all of this information to plan our inspection.

During the inspection

We spoke with eight people who used the service about their experience of the care provided. We spoke with 16 members of staff including the registered manager, deputy manager, senior care workers, care workers, registered nurses, the infection control lead, quality development manager and the chef.

We reviewed a range of records. These included eight people’s care records and multiple medication records. We looked at staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with 20 relatives by telephone to obtain their views on the service provided at Carpathia Grange. We emailed requests for feedback to staff members and received six responses and 11 relatives sent emailed feedback when they learned from the registered manager that we had inspected the service.

Updated 20 July 2021

About the service

Carpathia Grange is a residential care home providing personal and nursing care to 34 people aged 65 and over at the time of the inspection.

Carpathia Grange accommodates up to 62 people across three separate floors, each of which has separate facilities. One of the wings specialises in providing care to people living with dementia, another focusses on people needing nursing care. The premises are purpose built and were commissioned in 2019.

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

People were given their medicines as the prescriber intended, and in a way that met their individual needs. We have made recommendations to improve medicines administration.

Staff were safely recruited, and all necessary pre-employment checks were completed. We received feedback from several staff about their concerns that there were not sufficient staff deployed. The registered manager assured us that staffing was within Care UK’s dependency tool calculations. We made a recommendation to review the dependency tool to ensure adequate staffing levels had been met.

The provider had a robust infection prevention and control policy and staff adhered to procedures and wore PPE appropriate to the tasks they were completing. The premises were very clean and there were no malodours.

People and their relatives told us they felt the home was safe but if they had concerns, they could speak to staff. Staff were trained in safeguarding and could recognise the signs and symptoms of potential abuse.

Risks were assessed, and reviews and actions taken to minimise residual risks. The premises were safely managed however there were some works required to meet the actions following a fire risk assessment. These were due for completion. Regular checks and servicing of equipment, fixtures and fittings ensured they were safe for use.

Accidents and incidents were thoroughly investigated and learning from them shared amongst the team.

Peoples mental capacity had been assessed and necessary best interest decisions and applications to deprive people of their liberty were made. We noted there were DNACPR’s in place that had been issued by GP’s and hospital doctors that did not evidence discussion with family members.

Care plans were formulated and reviewed within the first week of people’s admission to Carpathia Grange.

Staff participated in an induction on commencing their post at Carpathia Grange and there was a broad range of training courses also completed.

Food and drink at Carpathia Grange was very good and the chef had been praised for their production of meals for people who needed specialist diets. We saw people receiving empathetic and appropriate support with their meals.

The premises were purpose built and were clean and well decorated. There were appropriate signs for people to navigate the building and a good selection of reminiscence areas.

People and relatives believed the care was good at Carpathia Grange and staff were also caring to people’s relatives. Dignity and privacy were maintained and when there were concerns about people’s dignity or privacy, the provider took steps to explore ways to protect people.

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 were supported to make choices and lead fulfilling lives. People contributed to their care plans if they were able and learning from day-to-day events was added to care plans to inform staff.

Staff communicated well with people however some communication plans and broader care plans lacked information that may have improved this. Other care plans would benefit from additional details.

There was a busy activities programme and people could choose to participate, have input from staff in their rooms or opt out. There were reminiscence activities throughout the dementia specialist areas of the service.

Complaints and concerns were responded to and a solution found for people. People would raise concerns should they have any and were confident they would be dealt with.

Staff participated in end of life care training and experienced staff worked with new staff to share best practice and experience.

There was a clear structure within the service and staff understood their roles within this. There were several meetings each with specific focus to ensure staff were well informed about relevant issues.

Meetings such as relatives’ meetings that would usually have been face to face had been held via Zoom calls during the pandemic. Relatives praised the service for keeping them informed and involved. A regular quality assurance questionnaire informed the provider of their performance and informed future developments.

The registered manager understood their responsibility under the duty of candour and kept relevant persons informed when things went wrong.

Positive links had been forged with local health and social care professionals to enhance the experience of people using the service.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

This service was registered with us on 7 November 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on our inspection schedule.

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.