CQC report explained · a nursing home
What the CQC found at The Grand Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust safeguarding systems, enough staff, safe recruitment and medicines given as prescribed. However, some records did not show how much people at risk of dehydration had drunk.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff had appropriate induction, training and supervision, and the home worked well with healthcare professionals.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were supported to make choices, express their views and maintain independence.
- Responsive?
- Good
- The ratings table gives Good, while the detailed section describes the service as exceptionally responsive and says the rating changed to Outstanding. Inspectors praised personalised activities, communication support and end of life care.
- Well-led?
- Good
- Inspectors found an open culture, strong management oversight and regular checks on incidents, accidents and quality. Staff and people spoke positively about how the home was run.
What inspectors found, March 2023
Rated Good overall; inspectors found kind, safe and highly individual care, with some drinking records needing improvement.
Inspectors visited without notice on 17 and 18 January 2023. They spoke with people living in the home, a relative, staff and healthcare professionals. They reviewed care records, medicines records, staff files and management records.
The home was rated Good overall. Safe, Effective, Caring, Responsive and Well-led were all shown as Good in the ratings table. Inspectors found enough staff, safe medicine systems, suitable training, clean premises and good leadership.
The home provided personalised care and a wide range of activities. Inspectors were particularly positive about helping people keep relationships, follow their interests, maintain independence and plan for the end of life.
Some records did not show how much certain people at risk of dehydration had drunk. Staff were reminded about this straight away. The inspection was prompted partly by a reported abuse incident, but inspectors did not examine that incident because it was under criminal investigation.
Personalised activities
The home helped people continue interests, build friendships and achieve personal wishes. Inspectors saw activities including reminiscence, choir, yoga, animal visits and trips into the community.
“The service enriched people's lives, by helping them fulfil their wishes and aspirations.” from the report
End of life support
Staff worked with people and families to record end of life wishes. The home offered a personalised palliative care box and arranged religious blessings when wanted.
“The service was particularly skilled at helping people and families explore and record their end of life wishes.” from the report
Kind and respectful care
Inspectors saw caring interactions and found that people's privacy, dignity, choices and independence were respected.
“People were treated in a kind and compassionate way by staff.” from the report
Safe medicines systems
Staff were trained and checked as competent to give medicines. Records were audited and inspectors found the medicine administration records accurate.
“Medicine administration records (MAR) were accurate and correct.” from the report
Good management oversight
The home had regular checks, reviewed incidents and shared learning with staff. Inspectors found leadership and governance well embedded.
“There was an open and transparent culture throughout the service.” from the report
Drinking records
needs fixingSome people at risk of dehydration did not have records showing how much they had drunk. The manager addressed this with staff through supervision immediately after inspectors raised it.
“However, some people who were at risk of dehydration and staff had not monitored how much they drank.” from the report
- 01How do you identify people at risk of dehydration, and how do you now record the amount they drink?
- 02How will you check that the new reminder to record drinking and catheter emptying amounts is being followed?
- 03The report's ratings table says Responsive is Good, but the detailed section says it changed to Outstanding. Which rating is the current official rating, and why is the report inconsistent?
- 04How are families involved in recording and reviewing end of life wishes?
- 05How do you make sure staffing levels change when people's needs increase?
This was an unannounced inspection that examined the overall service and all five key questions, including risks linked to a reported abuse incident, which inspectors said they did not examine because of a criminal investigation. This explanation was written from the published report of 8 March 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, February 2022
The Grand was inspected but not rated; inspectors found strong COVID-19 infection control and visiting arrangements.
This was a short-notice, announced inspection on 31 January 2022. It was a targeted inspection during the COVID-19 pandemic.
Inspectors looked at infection prevention and control, visiting arrangements and whether COVID-19-related staffing pressures affected care. They were assured that the home had suitable measures in place.
The home had supplies of personal protective equipment, regular cleaning schedules, infection control audits and arrangements for safe admissions, testing and visits. Inspectors also found that staff knew how to respond if someone developed COVID-19 symptoms or tested positive.
The service was inspected but not rated. This report does not give an overall quality rating or ratings for most areas of care.
Visitor safety
Visitors were asked for a negative lateral flow test, had temperature checks and used personal protective equipment. The home also used an electronic system to record visitors.
“Safe arrangements were in place for visitors. This included confirmation of a negative lateral flow test, temperature checks, and the use of personal protective equipment (PPE).” from the report
Infection control
The home had enough personal protective equipment, an up-to-date infection control policy and regular audits. Staff were seen using protective equipment correctly.
“There were adequate supplies of personal protective equipment (PPE) throughout the home.” from the report
Safe admissions and testing
The home had arrangements for testing and isolating new residents, and carried out testing in line with guidance for residents, staff and visitors.
“There were arrangements to admit people safely to the home. This included testing and isolation in line with guidance.” from the report
Cleaning and outbreak response
Cleaning schedules included high-touch areas. Staff knew how to put full infection control measures in place when someone developed symptoms, tested positive or had been exposed to the virus.
“Staff were trained and knew how to immediately instigate full infection control measures to care for a person who developed symptoms, who tests positive or who has been exposed to the virus” from the report
Inspectors raised no specific concerns in this report.
- 01How are your infection control, testing and visiting arrangements different now from those inspected on 31 January 2022?
- 02How do you assess and manage infection risks when a new resident is admitted?
- 03How would you support my relative if they developed symptoms of an infection or tested positive?
- 04How do you check that staff have enough personal protective equipment and use it correctly?
- 05What measures are in place if COVID-19-related staffing pressures affect the home?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated. This explanation was written from the published report of 16 February 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.
Every inspection of The Grand Care Home
3 rated inspections over 6 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Inspected but not ratedSafe: Inspected but not rated
- November 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016
Registered with the Care Quality Commission on 29 April 2016.
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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75 live-in carers within about an hour of Nottinghamshire
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Most charge £980 to £1,260 a week. 63 can care for a couple. 10 years' experience on average.
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