CQC report explained · a residential care home
What the CQC found at Grange Crescent
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors checked infection prevention and control. They were assured that the home managed infection risks, used protective equipment safely and welcomed visitors.
- Effective?
- Good
- People's outcomes were consistently good. Staff were trained, people's needs and choices were assessed, and people received support with food, drinks and healthcare.
- Caring?
- Good
- This question was not separately rated in this inspection. Inspectors observed caring and considerate interactions and people spoke positively about their care.
- Responsive?
- Good
- This question was not separately rated in this inspection. Care plans included people's individual choices and preferences.
- Well-led?
- Good
- Management was approachable and used audits, checks and feedback to identify and address issues. People and professionals gave positive feedback about the management and care.
What inspectors found, January 2023
Grange Crescent is rated Good; inspectors found kind, effective care and good management, with a small records issue still to improve.
This was an unannounced inspection. Two inspectors and an Expert by Experience visited on 13 December 2022. They spoke with 12 people, nine staff and two visiting professionals, observed care and reviewed records.
The home was clean and infection controls were effective. People were supported to make choices, eat and drink well, access healthcare and receive care from trained staff. Inspectors saw staff treating people with kindness and asking for consent before care.
The overall rating was Good. Effective improved from Requires Improvement at the last inspection. Well-led remained Good. Safe was inspected for infection control but was not re-rated, and the report does not give ratings for Caring or Responsive.
Infection control
Inspectors found the home clean and were assured that infection risks were being managed. Visitors could maintain contact with people living there.
“The home was clean, and people were protected from the risk and spread of infections.” from the report
Trained staff
Staff received training, supervision and appraisals. Inspectors found that staff understood people's needs and knew how to support them.
“A comprehensive training plan evidenced staff had received appropriate training to carry out their roles effectively.” from the report
Food and choice
People were offered choices, nutritious drinks and snacks. Staff supported people during meals and noticed when someone needed help.
“People were offered choices and staff checked people were enjoying their meals.” from the report
Open management
The management team used audits, staff checks and feedback to improve the service. People and staff said the management was approachable.
“A number of audits and checks were completed to help ensure continuous learning and improvement.” from the report
Some records needed tidying
minorInspectors said some records linked to Deprivation of Liberty Safeguards applications needed better housekeeping. This was a minor records shortfall, and the report says wider improvements had been made.
“We discussed with the registered manager how improvements to the 'housekeeping' of some records of applications for DOLS could be made.” from the report
- 01How have you improved the housekeeping and checking of records for Deprivation of Liberty Safeguards applications?
- 02How do you make sure staff keep their training, supervision and competence checks up to date?
- 03How are my relative's food preferences, snacks, drinks and need for help at meals recorded and reviewed?
- 04How do you involve my relative and family in care assessments and decisions about consent?
- 05When were Caring and Responsive last fully inspected, and what were their ratings?
This was an unannounced inspection focused on infection prevention and control under Safe, and on Effective and Well-led; Safe was not re-rated and the other areas were not separately rated in this report. This explanation was written from the published report of 12 January 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, September 2019
Grange Crescent was rated Good overall, but inspectors found that consent records, staff understanding and some care records needed improvement.
Inspectors carried out an unannounced visit on 15 August 2019. They spoke with people living in the home, relatives and staff. They reviewed care and medicines records, observed daily care, and checked the building and records.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were all rated Good. People said they felt safe, staff were kind, care was personal, activities were available and the home was well run.
Effective was rated Requires Improvement. Records about mental capacity, lasting powers of attorney and some changed dietary needs were not always complete or up to date. Staff training and understanding about the Mental Capacity Act and Deprivation of Liberty Safeguards also needed improvement.
The overall rating stayed Good compared with the previous inspection. However, the Effective rating fell from Good to Requires Improvement.
Kind and respectful care
People and relatives said staff were kind, knew people well and treated them with dignity. Inspectors observed staff supporting choice and independence.
“People and their relatives told us staff were kind and caring.” from the report
People felt safe
People said they felt safe. Inspectors found appropriate safeguarding, risk management, staffing and infection control arrangements.
“People told us they felt safe at Grange Crescent.” from the report
Personalised support
Care records included people's preferences and life histories. Staff knew people's needs and responded when they needed extra support or reassurance.
“People and their relatives confirmed staff provided care in accordance with their preferences.” from the report
Activities and social contact
The home offered activities inside and outside the home, based on people's interests. Inspectors saw people taking part and being meaningfully occupied.
“Grange Crescent provided a range of activities for people living in the home to ensure they were meaningfully occupied.” from the report
Medicines before food
needs fixingPeople usually received medicines as prescribed, but the home needed a more consistent system for medicines that had to be taken before food.
“The service needed to implement a more consistent system which ensured people received medicines that must be taken before food consumption at the correct time.” from the report
Mental capacity records and training
needs fixingCapacity assessments did not always clearly explain which decision was being assessed or how the conclusion was reached. Staff understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards was not comprehensive.
“Staff had completed training on the MCA and DoLS however we found their understanding of the MCA was not comprehensive.” from the report
Care records not always updated
needs fixingSome records had not been updated after people's risks or modified diets changed. This could make it harder for new or agency staff to follow the correct support.
“Recent changes made to two people's modified diets had not been updated in their support plans.” from the report
Some relatives and staff wanted more staff
minorInspectors found enough staff during the visit, but some relatives and most staff said an additional member of staff would allow more time with people, especially at mealtimes.
“Most staff told us they thought the service would benefit from having an additional member of staff on each shift so they could spend more time with people.” from the report
- 01How do you now make sure medicines that must be taken before food are given at the correct time?
- 02How do you check that staff understand the Mental Capacity Act and Deprivation of Liberty Safeguards in practice?
- 03How do you record capacity assessments and make sure they clearly explain the decision being assessed and the reason for the conclusion?
- 04How do you check that lasting powers of attorney are registered and that copies are kept in people's care files?
- 05How do you make sure changes to risks and modified diets are added promptly to care and support plans?
This was a planned, unannounced inspection covering all five key questions, the premises and the care provided. This explanation was written from the published report of 12 September 2019 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 Grange Crescent
4 rated inspections over 8 years: the service has held its Good rating throughout.
- January 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Goodstayed GoodEffective: Requires improvementWell-led: Good
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 30 October 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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