CQC report explained · a nursing home
What the CQC found at Alice Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention and control, including PPE, testing, cleaning, visiting and managing outbreaks. The home was also managing COVID-19-related staffing pressures.
- Effective?
- Good
- This question was not assessed in this targeted inspection.
- Caring?
- Good
- This question was not assessed in this targeted inspection.
- Responsive?
- Good
- This question was not assessed in this targeted inspection.
- Well-led?
- Good
- This question was not assessed in this targeted inspection.
What inspectors found, February 2022
Inspected but not rated; inspectors found strong infection control, with some relatives unclear about essential care giver visits.
This was an announced, targeted inspection on 27 January 2022. Inspectors focused on infection prevention and control during the COVID-19 pandemic, staffing pressures and whether these affected care. They also spoke by telephone with people living at the home and relatives.
Inspectors were assured that the home was managing infection risks. Staff used protective equipment correctly, testing was taking place, the home was clean and visiting arrangements helped people keep in touch with family and friends. Staffing absence linked to COVID-19 was being managed.
The service was inspected but not rated. This means the visit did not produce a new overall quality rating. The Safe question was also inspected but not rated, and the other four questions were not assessed in this targeted visit.
Infection control
Inspectors were assured that infection risks were being managed. Staff had up-to-date training and were observed using PPE and social distancing guidance.
“We were assured that the provider was using PPE effectively and safely.” from the report
Clean environment
The home was visibly clean, with extra cleaning arrangements for frequently touched surfaces.
“The home was visibly clean. Cleaning schedules were in place with additional cleaning protocols to ensure all high touch points were regularly sanitised.” from the report
Keeping families connected
The home used visits, video calls and telephone calls to help people maintain relationships, including during periods when visiting was restricted.
“The use of spare rooms and risk assessing, enabled visits to safely take place in order that people were able to maintain relationships important to them.” from the report
Healthcare links
The home had close links with healthcare professionals and obtained medical advice promptly when needed.
“The home maintained close links with healthcare professionals including the local GP practice.” from the report
Essential care giver information
minorSome relatives did not understand the essential care giver role or what it could mean for them. Inspectors suggested that the manager contact relatives again with an explanation.
“some relatives told us they were not familiar with this role of what it could mean for them as a family member of someone living in the care home.” from the report
- 01How do you now explain the essential care giver role to relatives?
- 02What visiting arrangements apply during an outbreak or other restriction?
- 03How are COVID-19-related staff absences covered, and what effect could this have on care?
- 04How often are high-touch surfaces cleaned and how is this checked?
- 05What arrangements are in place for testing residents and care workers?
This was a targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it did not rate the service overall or assess Effective, Caring, Responsive or Well-led. This explanation was written from the published report of 12 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2020
Rated Good after major improvements from Inadequate; inspectors found safe, kind care, but staffing and leadership stability still need monitoring.
This was a comprehensive inspection carried out on 25 November and 10 December 2020. Inspectors spoke with people, relatives and staff, reviewed care and recruitment records, and checked infection prevention measures.
The home had improved significantly since the previous inspection. Inspectors found enough staff, safer medicines management, better care plans, improved nutrition support, kind staff and stronger leadership. All five areas were rated Good.
The previous inspection, published on 31 March 2020, rated the home Inadequate overall and found five breaches of regulations. The home had been in Special Measures, but it was no longer Inadequate or in Special Measures after this inspection.
Safer care planning
Risks relating to nutrition, skin integrity and people's wider care had been reviewed. Staff understood these risks and how to support people safely.
“Assessment of risks associated with people's care had been accurately completed and guided staff in how risks were to be reduced.” from the report
Kind and respectful staff
People and relatives described staff as caring, patient and respectful. Inspectors saw staff spending time with people and supporting their independence.
“People were supported by caring staff and a management team who knew them well.” from the report
Improved leadership
The home had introduced regular audits, checks and walk-arounds. Staff and relatives said communication and support from management had improved.
“Since we last inspected robust quality assurance systems had been introduced to ensure care records and other documentation was complete, accurate and contemporaneous.” from the report
Improved infection control
Inspectors were assured that the home used PPE safely, supported testing and had measures to prevent and manage infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Activities were mixed
minorFeedback about activities was mainly positive, but not entirely consistent. The home had recently recruited to vacant activities posts and was still building its approach.
“At this inspection we received mixed but mainly positive feedback about the range of activities and opportunities for people to engage in hobbies.” from the report
New admissions
needs fixingThe home had paused new admissions after the previous inspection. It planned to restart them slowly, and recognised that nursing staff needed further training in pre-admission assessments.
“The registered manager had recognised and identified that due to no one being admitted to the home and no assessments carried out of anyone thinking of moving to the home, further training was needed for nursing staff in carrying out pre-admission assessments.” from the report
Minor medicines records issue
minorTwo medicines administration records needed clearer directions. Nursing staff corrected this immediately and inspectors found no harm had occurred.
“Two minor amendments were needed to medicine administration records (MARs) to ensure clear directions were in place.” from the report
- 01How will you monitor staffing levels if the number of people living here increases?
- 02What training do nursing staff now receive for pre-admission assessments?
- 03How will you keep the recent improvements in place, given the four manager changes in the previous year?
- 04What activities are available for people living with dementia, and how do you check that they suit each person's interests?
- 05How do you check that medicines administration records contain clear directions?
This was a comprehensive inspection covering all five key questions, including infection prevention and control measures, and it checked whether earlier legal breaches had been addressed. This explanation was written from the published report of 19 December 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Alice Grange
8 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- February 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2020Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2020Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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