CQC report explained · a nursing home
What the CQC found at The Grange Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2022
The Grange Care Centre was rated Requires Improvement; inspectors found kind care but repeated medicines, care planning and management concerns.
This was an unannounced follow-up inspection on 17 May 2022. Inspectors spoke with people, relatives, staff and healthcare professionals. They observed care, checked records and medicines, and looked at infection control, equipment and the premises.
The home was not always safe. Some medicines were given at the wrong times, and records did not always contain the required information. People and staff also said there were times when staffing levels or deployment meant people waited for care.
Care was generally kind and respectful. Staff knew people well, offered choices and supported privacy and independence. Training, healthcare support, infection control and safeguarding systems were generally suitable.
The overall rating remained Requires Improvement, as did Safe, Responsive and Well-led. Effective stayed Good, while Caring improved from Requires Improvement to Good. The provider remained in breach of three regulations and was asked to submit an action plan.
Kind and respectful staff
People generally had good relationships with staff. Inspectors saw staff offer reassurance, choices and help without rushing people.
“We observed staff providing gentle reassurance and care.” from the report
Training and support
Staff completed induction and training. An in-house trainer observed their work, checked their skills and provided further training.
“The provider employed an in-house trainer who worked at the service alongside staff, observing practice, assessing their skills and providing training based on these assessments.” from the report
Healthcare support
People could access doctors, dentists and other healthcare professionals. Nurses monitored changes and made referrals when needed.
“People's healthcare needs were met, and they had access to external healthcare services.” from the report
Infection control
The home had infection control policies, training and protective equipment. The environment and equipment were kept clean.
“The environment and equipment used to support people were kept clean and there were regular checks and audits to make sure a good standard of cleanliness was maintained.” from the report
Medicines not always given safely
seriousMedicines for three people were not given at the prescribed times. Some electronic medicine records also lacked required information. This was a repeated breach and created a risk that medicines would not work as intended.
“Medicines were not always administered as prescribed.” from the report
Care plans were not personal or consistent
seriousSome plans used generic wording, included incorrect details or did not explain how identified needs should be met. This could make it harder for staff to provide consistent care.
“People's care was not always planned in a personalised way.” from the report
Staffing and waiting times
needs fixingPeople, relatives and staff said people sometimes waited for care, particularly at night and at weekends. Staff said they did not always have enough time for quality care and interaction.
“People using the service and their relatives told us they felt there was not always enough staff.” from the report
Activities did not suit everyone
needs fixingSome people were not supported to take part in activities, especially people who spent time in their rooms. Some younger adults wanted activities better suited to their age and interests.
“Some of the people who spent time in their rooms, either through choice or because of their needs, did not engage in any activities throughout the day of our inspection and told us this was often the case.” from the report
Quality checks were not effective enough
seriousAudits did not identify problems with medicines, personalised care plans or records showing that planned care had been given. The provider was in breach of the good governance regulation.
“The provider's systems and processes for monitoring and mitigating risk had not always been operated effectively.” from the report
- 01How do you now check that medicines requiring specific times are given at those times?
- 02How do you make sure each person's care plan is personal, accurate and consistent across different care needs?
- 03What has changed about staffing deployment, especially at night and weekends, and how do you check people are not waiting too long for care?
- 04How do you provide suitable activities for people who stay in their rooms and for younger adults?
- 05What action plan did you submit to CQC, and what progress has been made on the three breached regulations?
This was an unannounced follow-up inspection covering all five key questions, with additional checks on infection control and a thematic probe about oral healthcare. This explanation was written from the published report of 21 June 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, April 2021
The Grange Care Centre was rated Requires Improvement; inspectors found kind care and good staff support, but medicines and care records were not always safe or complete.
Inspectors carried out an unannounced inspection on 2 March 2021. They spoke with people, relatives, staff and health professionals. They checked care records, medicines, infection control, staffing and the home's management systems.
The home was rated Requires Improvement overall. Safe, Caring, Responsive and Well-led were also rated Requires Improvement. Effective was rated Good.
Inspectors found medicines were not always recorded or managed safely. Some care records did not show that planned care, including repositioning to protect skin, had happened. There were also concerns about whether all people's needs were consistently met and about communication with some relatives.
There were positive findings too. People generally said staff were kind and that they felt safe. Staffing, training, infection control, healthcare support and consent arrangements were found to be good. The provider said it had started making improvements after the inspection.
Kindness and comfort
Most people and relatives gave positive feedback about staff. Inspectors saw staff offering choices, speaking politely and comforting someone who became distressed.
“Except for one incident, we saw staff were kind, caring and considerate towards people.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs, with reduced reliance on agency workers. Staff received induction, training, supervision and competency checks.
“There were enough staff deployed to meet people's needs and keep them safe.” from the report
Infection control
The home had suitable infection-control procedures, enough protective equipment and regular COVID-19 testing. Inspectors found the home was clean.
“The provider's systems and processes helped to prevent and control infection.” from the report
Healthcare support
Nurses monitored people's health and made referrals when needed. Inspectors were told that staff worked well with visiting healthcare professionals.
“The healthcare professionals we spoke with explained the staff made timely referrals and followed their recommendations and guidance to help meet people's needs.” from the report
Learning from complaints
The home investigated complaints and used feedback to make changes. Managers apologised and explained what they had done to complainants.
“We saw there had been learning from complaints, and changes made to the service, along with staff meetings, reflective practice and improved communication as a result of complaints and feedback from people, their relatives and staff.” from the report
Medicines records
seriousMedicines were not always recorded accurately. This included PEG medicines, insulin doses and missing signatures, creating a risk that medicines might not be given as prescribed.
“We found no evidence people were being harmed. However, failure to manage medicines in a safe way was a breach of Regulation 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Care records and repositioning
seriousRecords did not clearly show that one person was repositioned as often as recommended to reduce the risk of further skin damage. Care plans were also missing for some people with seizures.
“Therefore, it was not clear whether the person was being cared for according to their plan of care.” from the report
Respect and attention
needs fixingInspectors saw one interaction that was not respectful or kind. Some relatives said people did not always receive enough attention or were spoken to in a patronising way.
“During the inspection we witnessed one interaction which was not respectful or kind.” from the report
Loneliness and activities
needs fixingSome activities and visits had been reduced during the COVID-19 pandemic. Some people said they felt lonely, although the home offered individual activities and video calls.
“Some people expressed this with one person telling us, ''It is lonely here,'' and a relative commenting, ''My impression is that [person] feels very lonely.''” from the report
Communication with relatives
needs fixingSome relatives said staff did not always share information, consult them or return their calls. The manager had tried to improve communication.
“Some relatives felt further improvements were needed.” from the report
- 01What changes have been made to prevent errors in medicine records, particularly for insulin and medicines given through PEG tubes?
- 02How do you check that repositioning, seizure care and other planned care have actually been completed and recorded?
- 03What is the current process for keeping relatives informed about changes in a person's care and returning their calls?
- 04How do you identify and respond when someone is lonely, especially if visits or group activities are reduced?
- 05What action has been taken following the Regulation 12 breach, and what evidence can you show that the changes are working?
This was an unannounced planned inspection covering all five CQC key questions and infection control; it was the first inspection since the current provider took over registration. This explanation was written from the published report of 23 April 2021 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 Grange Care Centre
8 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- June 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015Inspected but not ratedSafe: Inadequate
- February 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2020
Registered with the Care Quality Commission on 13 January 2020.
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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