CQC report explained · a residential care home
What the CQC found at Attleborough Grange
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks had been identified, but staff did not always follow people's care plans. Inspectors also found a medicines recording error and some equipment that needed cleaning.
- Effective?
- Good
- Staff were trained and supported, people were helped with food and drink, and healthcare needs were reviewed and referred on in a timely way.
- Caring?
- Good
- People and relatives were positive about staff kindness. Staff respected privacy, dignity, independence, beliefs and personal choices.
- Responsive?
- Good
- Care plans reflected people's preferences and were reviewed. People were offered activities, individual time, communication support and end of life care.
- Well-led?
- Requires improvement
- The culture and management visibility had improved, but audits did not always identify medicines problems or failures to follow care plans.
What inspectors found, April 2023
Attleborough Grange is rated Requires Improvement overall; inspectors found kind, responsive care, but risks, medicines checks and management oversight were not always reliable.
Inspectors made an unannounced, comprehensive visit on 22 February 2023. They spoke with people, relatives, staff and healthcare professionals. They observed care and reviewed care records, medicines records, training, recruitment and quality checks.
The home had enough staff and staff were recruited safely. People were treated with kindness and respect. Their care was generally personalised, and people had access to activities, food, drink and healthcare. The ratings for Effective, Caring and Responsive were Good.
The home was not always safe or well-led. Some risks were not managed as care plans said they should be. Inspectors also found errors and gaps in medicines checks, equipment cleanliness and checks of important records. The provider took immediate action on some issues during and after the visit.
The overall rating remains Requires Improvement. Previous breaches found in 2019 had been addressed, so the home was no longer in breach of regulations at this inspection. However, further improvement was still needed.
Enough staff
Inspectors found enough staff to provide safe care. Relatives said staff were available and responded to requests for help.
“There were enough staff to provide safe care. Feedback from staff confirmed this.” from the report
Kind and respectful care
People and relatives described staff as kind and caring. Staff supported privacy, dignity, independence and personal beliefs.
“All the staff we spoke with enjoyed their work and were motivated to provide people with a warm and caring environment.” from the report
Good healthcare support
People's health was reviewed regularly and staff worked effectively with healthcare professionals. Communication had improved since the previous inspection.
“Records showed people's health was regularly reviewed and people received timely care.” from the report
Personalised activities
Activities were based on people's interests and included individual time for people who spent more time in their bedrooms.
“Improvements had been made to ensure people cared for in their bedroom had more opportunities for social engagement.” from the report
Care plans were not always followed
seriousSome risks were not managed as set out in people's care plans. This included a person at high risk of choking being supported to eat while lying down, missing seizure-monitoring equipment and missed repositioning support.
“However, some identified risks were not always managed in line with people's care plans.” from the report
Medicines checks
seriousOne person's as-required medicine was recorded as being given every day. Inspectors also found that pharmacist advice had not been sought before some medicines were crushed and given in drinks.
“However, improvement was needed in the monitoring of medicines.” from the report
Equipment cleanliness
needs fixingThe home was generally clean and tidy, but inspectors found a dirty walking aid and a stained, rusty commode. The manager acted at the time and introduced stronger checks.
“For example, one person's walking aid was notably dirty, and another person's commode was stained and rusty.” from the report
Management checks
needs fixingQuality systems were in place, but checks did not always identify medicines problems or when staff were not following care plans.
“Checks of records had not identified when risks were not always managed in line with people's care plans.” from the report
- 01What checks now make sure staff follow each person's care plan for choking, epilepsy and repositioning risks?
- 02How do you check that medicines are recorded correctly, especially as-required medicines?
- 03What advice has the home received from a pharmacist about crushing medicines and giving them in food or drinks?
- 04How often are walking aids, commodes and other care equipment cleaned and checked?
- 05What evidence can you show that the service improvement plan has fixed the gaps in medicines and care-record audits?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 1 April 2023 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
Inspected but not rated; inspectors were assured that infection prevention and control measures were safe.
This was an announced, targeted inspection on 26 November 2020. It was carried out because of coronavirus outbreaks and focused only on infection prevention and control.
Inspectors found good arrangements for visitors, including a one-way system, changing rooms and a self-contained visitor room. Families were given regular updates about COVID-19 cases in the home.
The home had cleaning schedules, systems for sanitising or quarantining belongings, and a COVID-19 tracker to monitor people's health, testing and isolation. Inspectors were assured that infection prevention and control procedures were being followed.
The service was inspected but not rated. This means the report does not give an overall quality rating or ratings for the other four questions.
Visitor safety
The home used a one-way entry and exit system, designated changing rooms and a self-contained visitor room. Families received regular updates about COVID-19 cases.
“Families were contacted either daily or weekly with updates so information about COVID-19 cases in the home could be shared to ensure transparency.” from the report
Cleaning and hygiene
Cleaning schedules were placed above touch points so cleaning could be carried out and checked throughout the day.
“Wipeable cleaning schedules were located above all touch points to ensure regular cleaning was carried out and checked throughout the day.” from the report
Monitoring people's health
Staff were trained to notice less obvious COVID-19 symptoms. A tracker recorded changes in health and wellbeing, testing and isolation dates.
“Staff were taught 'softer' symptoms of COVID-19 to monitor more subtle changes in people's health and a COVID-19 tracker was recently implemented.” from the report
Safe admissions
The home had a sanitising and laundry programme for people arriving from hospital or the community. Belongings were sanitised, washed or quarantined.
“Bags brought into the home would either be sanitised, washed or quarantined for three days.” from the report
Inspectors raised no specific concerns in this report.
- 01How have your infection prevention and control arrangements changed since the 26 November 2020 inspection?
- 02How do you currently manage visits, including the use of changing rooms and the self-contained visitor room?
- 03How do you monitor less obvious changes in people's health and act on information recorded in the COVID-19 tracker?
- 04What is your current process for safely admitting people from hospital or the community and handling their belongings?
- 05How do you prevent and manage an infection outbreak, and how would families be kept informed?
This was a targeted inspection of infection prevention and control practices only; it was not a full inspection and the service was inspected but not rated. This explanation was written from the published report of 9 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 Attleborough Grange
4 rated inspections over 7 years: the service has slipped, from Outstanding to Requires improvement.
- April 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- September 2020Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2018Gooddown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- May 2016OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Outstanding
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Warwickshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.