CQC report explained · a nursing home
What the CQC found at Grange Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments were in place, but records for food and fluid intake and positional changes were not always completed. Inspectors also found safe staffing, medicines, safeguarding and infection control arrangements.
- Effective?
- Requires improvement
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in the overall rating.
- Well-led?
- Requires improvement
- Quality checks did not identify or improve problems with risk monitoring and care records. The provider breached Regulation 17 because its governance systems were not effective.
What inspectors found, July 2022
Requires Improvement; inspectors found caring staff and safe medicines, but incomplete care records created risks.
This was an unannounced focused inspection on 11 May 2022. Inspectors looked only at Safe and Well-led because they had received concerns about nursing care. They spoke with people, relatives, staff and visiting professionals, and checked care, medicine, recruitment and management records.
The home had risk assessments and care plans, but records did not always show that food, fluids and positional changes had been monitored as required. Inspectors could not be sure that people had always received the safe care set out in their plans.
Inspectors found that medicines, infection control, safeguarding, staffing and recruitment were managed appropriately. People appeared comfortable with staff, and relatives said they felt their family members were safe.
The overall rating remains Requires Improvement, as do Safe and Well-led. The home has had this rating for the last two consecutive inspections. The provider breached Regulation 17 because its systems did not identify risks or keep accurate, up-to-date records.
Caring staff
People appeared comfortable and happy with staff, who were observed to be caring and patient.
“It was observed during the inspection that people were comfortable and happy in the presence of staff who interacted with then in a caring and patient manner.” from the report
Safe medicines
Medicines were administered, recorded, stored and disposed of safely, including controlled and as-needed medicines.
“Medicines were managed safely.” from the report
Safeguarding
Staff had safeguarding training and knew how to recognise and report concerns. People and relatives said they felt safe.
“People told us they felt safe with staff and family members told us they were confident their relatives was kept safe at the home.” from the report
Staffing and recruitment
Recruitment checks were completed and inspectors saw an appropriate number of staff on duty. Regular agency staff were familiar to people and relatives.
“Safe staffing levels were maintained through the use of agency staff.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment and testing.
“We were assured that the provider was using PPE effectively and safely.” from the report
Incomplete care monitoring
seriousRecords did not always show that people had received the planned food, fluids and positional changes. This meant inspectors could not be assured that care needs were consistently monitored.
“Records used to record and monitor aspects of people's care including food and fluid intake and positional changes were not always completed to show the care was provided.” from the report
Management visibility
minorFeedback about management was mixed. Some people found the manager helpful, while others said the manager was often in the office and some people were unsure who the manager was.
“However, other feedback indicated that the manager was in his office and some people were unsure of who the registered manager was.” from the report
- 01How do you now check that food and fluid intake records are completed accurately every day?
- 02How do you record and audit positional changes for people who need them?
- 03What extra auditing system was introduced after the inspection, and what problems has it found or corrected?
- 04How will you make sure care records are accurate and up to date?
- 05How will the manager remain visible and make sure people know who is responsible for running the home?
This was an unannounced focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 7 July 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, August 2019
Grange Nursing Home was rated Requires Improvement; inspectors found kind, responsive care and safer systems, but improvements were recent and the home had only just left special measures.
This was an unannounced follow-up inspection on 11 July 2019. Inspectors spoke with people living in the home, relatives, staff, the provider, the manager and a visiting GP. They observed care and checked care, medicines, staffing and management records.
The home had improved greatly since its previous Inadequate rating. Medicines, risk assessments, staff training, nutrition records and activities had improved. People said staff were kind, respectful and treated them with dignity. The caring and responsive areas were rated Good.
The overall rating was Requires Improvement. Safe, effective and well-led were also Requires Improvement because the improvements had happened over a short time and had not yet been shown to last. The home was no longer in breach of regulations and was no longer in special measures.
Kind and respectful care
People appeared comfortable with staff. They said staff listened to them, treated them with dignity and respected their choices.
“People told us staff were kind and treated them with dignity and respect.” from the report
Safer medicines
Inspectors found that time-sensitive medicines were given correctly and records were complete. Storage and disposal had also improved.
“Time sensitive medication were administered appropriately, and all documentation had been fully completed.” from the report
Better activities
The home had introduced a wider range of activities based on people's interests. Inspectors saw activities including bowls, walks, arts and crafts, quizzes and fishing.
“At the last inspection the provider had no meaningful activities in place. During this inspection we saw how this had significantly improved.” from the report
Choice of food
People could choose meals and request alternatives. Inspectors found that nutrition and fluid records were being updated and acted on.
“People told us "The food is excellent. We're spoilt for choice” from the report
Improvements need to last
needs fixingThe main concern was that many changes had been made only recently. The provider and manager needed to show that the new standards would be maintained.
“However, these improvements had happened over a short period of time. This needs to be sustained by the registered provider and manager.” from the report
Some building work remained
needs fixingThe environment had improved, but inspectors found that this work was not complete. Further improvements were planned.
“Improvements had been made to the environment. However we saw that this was not completed” from the report
Manager registration pending
minorThe manager was responsible for running the home but was not yet registered with the CQC. The report says the registration process was under way.
“The current manager was not registered with the Commission, however they were going through the registration process.” from the report
- 01How are you checking that the recent improvements in medicines, risk management and care records are being maintained?
- 02What environmental and building work is still outstanding, and when is it expected to be completed?
- 03What is the current position on the manager's CQC registration?
- 04How are people's food, fluid and weight records reviewed, and what happens when a concern is identified?
- 05How are activities matched to each person's interests, and how are people who prefer one-to-one time supported?
This was an unannounced follow-up inspection covering all five key questions after the previous Inadequate rating and special measures. This explanation was written from the published report of 8 August 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 Nursing Home
6 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- March 2019Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- June 2013
Registered with the Care Quality Commission on 3 June 2013.
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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