CQC report explained · a residential care home
What the CQC found at Nicholl Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were considered safe, with enough staff, suitable recruitment checks and risk assessments. People managed their own medicines with staff monitoring, and the report says this had improved since the last inspection.
- Effective?
- Good
- Staff had suitable training, supervision and support. People were helped to make choices about food, healthcare, activities and moving towards more independent living.
- Caring?
- Good
- People said staff were kind, friendly and respectful. Inspectors saw people making their own decisions and being supported to maintain their privacy, dignity and independence.
- Responsive?
- Good
- Support plans reflected people's needs and preferences, and reviews involved people. There was a complaints process, although complaints were not kept in a formal log at the time of the inspection.
- Well-led?
- Requires improvement
- Management oversight was not reliable enough. The call bell system was not suitable in an emergency, regular quality audits could not be evidenced since 2017, and evidence about gathering people's views was unclear.
What inspectors found, March 2019
Nicholl Grange was rated Good overall, but inspectors found weaknesses in management checks and the emergency call bell system.
This was an unannounced inspection by one inspector on 17 January 2019. The inspector spoke with people living in the home, staff and managers. They reviewed care records, medicines records, complaints, accidents and other management records.
The home was rated Good for safe, effective, caring and responsive care. People were described as safe, independent and supported to make their own choices. Staff were kind, trained and understood people's needs. Medicines management had improved since the previous inspection.
The well-led rating was Requires Improvement. The emergency call bell could not reliably be heard at night or used by people living in nearby flats. Quality checks had not found this problem, and the provider could not show regular quality audits since 2017. The overall rating remained Good, but the home needed to improve its oversight.
Safe medicines support
People managed their own medicines, with staff monitoring the process and checking that medicines were taken and ordered safely. This addressed a concern from the previous inspection.
“This was a concern identified at the last inspection, which the provider had actioned.” from the report
Kind and respectful staff
People said staff were kind and friendly. Inspectors saw a relaxed environment where people were supported with dignity and respect.
“The interaction between people and staff demonstrated a relaxed and comfortable environment.” from the report
Independence and choice
People chose how to spend their time, where to go and how their rooms looked. The home also developed independent living flats.
“The provider promoted an environment that empowered people to live independently.” from the report
Personalised support
Support plans explained how people wanted to be supported, and reviews involved the people receiving care.
“Support plans were in place and showed how people wanted to be supported.” from the report
Staff training
Staff received regular training and supervision across areas relevant to people's needs.
“We saw evidence that staff had access to regular training covering a range of areas, for example, food hygiene, diabetes, fluids and nutrition and challenging behaviour.” from the report
Emergency call bell
seriousThe call bell could not be heard by sleeping staff at night and was not suitable for people living in nearby flats. This created a risk that someone might not get help in an emergency.
“This meant the provider's current call bell system could not be relied on or was suitable in an emergency.” from the report
Weak quality checks
needs fixingManagement checks had not found the call bell problem. The provider also could not show that quality audits had been carried out regularly since 2017.
“We were unable to see any evidence that the provider carried out any quality assurance audits since 2017 to show they were regularly monitoring the service quality.” from the report
Limited evidence of people's views
minorPeople said they had not completed surveys, and the manager could not initially show evidence of how people's views were gathered. Later information did not make clear whether feedback could be anonymous.
“However, it was unclear as to whether people could share their views anonymously.” from the report
Complaints not formally logged
minorThe home kept copies of complaints and their outcomes, but did not keep a formal complaints log. The manager said a log would be introduced immediately.
“The registered manager kept a copy of all complaints and their resolution, but this was not a log.” from the report
- 01Has the emergency call bell system been changed so that sleeping staff and people in the nearby flats can get help quickly?
- 02How often are quality assurance audits and spot checks now carried out, and can families see the results?
- 03How are people's views gathered, including whether they can give feedback anonymously?
- 04Has a formal complaints log been introduced, and how are complaints followed up?
- 05How is support reviewed for people who are preparing to move into more independent accommodation?
This was a planned, unannounced inspection that looked at the care, premises, records and management of the home across all five CQC questions. This explanation was written from the published report of 13 March 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 Nicholl Grange
2 rated inspections over 3 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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.
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