CQC report explained · a nursing home
What the CQC found at Orrell Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention, protective equipment, testing, cleaning, safe admissions and visiting arrangements. The provider also said it had measures to manage 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, January 2022
Inspected but not rated; inspectors found strong infection control and visiting arrangements during the COVID-19 pandemic.
This was an announced, targeted inspection on 11 January 2022. Inspectors looked at infection prevention and control, visiting arrangements and the effect of COVID-19 staffing pressures.
Inspectors found good supplies of protective equipment, regular testing and screening for visitors. Staff were observed using protective equipment correctly. The home was clean and hygienic, with extra cleaning taking place throughout the day and night.
The home supported contact between residents and their families, including through essential carers, telephone calls and video calls. The inspection did not give an overall quality rating. The safe question was inspected but not rated.
Infection control
Inspectors found good supplies of protective equipment, hand sanitiser and clear reminders about infection control. Staff were observed using protective equipment correctly.
“The home had good supplies of Personal Protective Equipment (PPE) for staff and visitors to use.” from the report
Clean environment
The home was clean and hygienic. Cleaning schedules had been reviewed and extra cleaning was carried out during the day and night.
“The home appeared clean and hygienic throughout. Daily cleaning schedules were implemented by housekeepers.” from the report
Family contact
Residents and families were supported to keep in contact through essential carers, planned visits, telephone calls and video calls.
“People living in the home and their family were supported to maintain contact.” from the report
Testing and screening
Regular COVID-19 testing was in place for residents, staff, essential carers and visitors. Visitors also went through screening before entering.
“A programme of regular COVID-19 testing for both people in the home, staff, essential carers and visitors to the home was implemented.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you managing staffing pressures now, and what happens if COVID-19 or other illness affects staffing?
- 02What are the current visiting arrangements, including the use of essential carers?
- 03How often are residents and staff tested when there is an infection concern?
- 04How do you check that staff and visitors use protective equipment safely?
- 05How has the home's infection prevention and control policy changed since this inspection?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not assess the other four questions and the service was not rated. This explanation was written from the published report of 20 January 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, November 2019
Rated Good; inspectors found safe, kind and well-organised care, with some records and care planning still needing improvement.
This was an unannounced inspection on 21 and 22 October 2019. Two inspectors and an Expert by Experience spoke with people, relatives and staff, observed care and checked care, medicines, recruitment and management records.
The overall rating was Good. Each of the five areas was rated Good: Safe, Effective, Caring, Responsive and Well-led. People generally felt safe, well cared for and listened to. Inspectors found enough staff, safe recruitment, clean surroundings, good food and effective links with health professionals.
The home had improved since its previous comprehensive inspection, which was rated Requires Improvement in November 2018. A focused inspection in February 2019 found that earlier legal breaches had been addressed and the service had improved to Good in the areas checked. This inspection found that those improvements had been maintained.
Inspectors still recommended stronger recording of mental capacity assessments and best-interest decisions. Care plans were being moved to a new electronic system, and more detailed personal information was still being added.
People felt safe
People and relatives said they felt safe. Risks were assessed and reviewed, and there were enough staff to meet people's needs.
“People felt safe living at Orrell Grange and their relatives echoed this.” from the report
Kind and respectful care
Inspectors saw warm interactions and found that staff knew people well. Relatives described the care as loving and caring.
“We observed warm and caring interactions between people and staff, which showed they knew each other well.” from the report
Good food and hydration support
The food was homemade, nutritious and varied. Staff supported people's individual dietary needs and offered regular snacks and drinks.
“The food was freshly home-made and nutritious. There was plenty of choice on offer, with lighter and heavier options, as well as people's special requests.” from the report
Effective health support
The home worked with health professionals and made appropriate referrals. Inspectors saw evidence of effective support for wounds and pressure sores.
“The service worked with a variety of health professionals to maintain and promote people's health and wellbeing.” from the report
Supportive leadership
People, relatives and staff spoke highly of the manager and provider. Meetings, surveys, newsletters and audits helped involve people and track improvements.
“A variety of checks and audits were in place to help ensure the safety and quality of the service.” from the report
Capacity decisions needed stronger records
needs fixingInspectors found that best-interest decisions and some mental capacity assessments were not recorded robustly enough. They made a recommendation for this to be reviewed.
“We recommend the service review the structure, robustness and recording of mental capacity assessments and best interest processes regarding specific decisions in line with best practice guidance.” from the report
Care plans were still being developed
needs fixingThe new electronic care planning system was not yet complete. Inspectors wanted more detail about people's backgrounds, preferences, needs and what might cause distress.
“There was ongoing work to continuously add more person-centred information based on staff's evident good knowledge of people.” from the report
Some medicines guidance could be more personal
needs fixingGuidance for medicines given when needed contained only basic information. Inspectors said it could better explain what staff should try before giving sedatives.
“We considered that at times additional person-centred detail in protocols may improve their effectiveness” from the report
Some staff supervision needed improvement
minorStaff had generally received formal supervision, but the frequency needed to improve. The manager was addressing this.
“The frequency of formal supervisions needed to be improved, which the registered manager was addressing.” from the report
- 01How are mental capacity assessments and best-interest decisions recorded for my relative?
- 02How far has the move to the electronic care planning system been completed, and does my relative's plan include their life story, preferences and signs of distress?
- 03How do you decide when to give medicines prescribed as needed, and what other approaches are tried first?
- 04How often will staff caring for my relative receive supervision and support?
- 05How do you check that audits and safety checks have been completed properly and that actions are followed through?
This was an unannounced planned inspection covering all five key questions and checking whether improvements found at the February 2019 focused inspection had been sustained. This explanation was written from the published report of 2 November 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 Orrell Grange
7 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- January 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- November 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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Most charge £980 to £1,270 a week. 34 can care for a couple. 11 years' experience on average.
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