CQC report explained · a residential care home
What the CQC found at The Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention, testing, protective equipment, cleaning, visiting and safe admissions. They were only somewhat assured that the infection-control policy was up to date because it did not specifically refer to COVID-19.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, March 2022
Targeted inspection found good infection-control arrangements, but the home was inspected and not rated.
Inspectors visited the home on 24 February 2022. This was an announced, targeted inspection about infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19.
They found the home was following guidance on testing, isolation, visiting, cleaning and protective equipment. Risks to people's health and safety were assessed, and inspectors said people were protected from cross infection.
There were two issues to address. The infection outbreak policy did not specifically cover COVID-19, and evidence that agency staff had been vaccinated had not arrived at the time of the visit. The manager updated the policy and received the vaccination confirmation after the inspection.
The home was not given an overall quality rating. Safe was recorded as inspected but not rated, so this report does not provide a Good, Requires improvement or Inadequate rating.
Infection protection
The home assessed health and safety risks and protected people from cross infection, including COVID-19.
“Risks to people's health and safety were being assessed and people were protected from the risk of cross infection, including COVID-19.” from the report
Testing and guidance
The home followed guidance on isolation and testing for residents, staff, visitors and visiting professionals.
“Government guidance was being followed in relation to isolation criteria and testing programmes for service users, staff, visitors and visiting professionals.” from the report
Clean environment
Inspectors found the home clean and hygienic, with protective equipment available throughout.
“The environment was clean and hygienic throughout and fully stocked Personal Protective Equipment (PPE) stations were positioned throughout the home.” from the report
Family confidence
Four family members recently spoken to by inspectors gave positive feedback and said their relatives felt safe living at the home.
“All family members told us they felt their relatives were safe living at The Grange.” from the report
COVID-19 policy
needs fixingThe infection outbreak policy covered several infections but did not specifically cover COVID-19. The manager addressed this after the inspection.
“Although there was a contingency plan in place in relation to the pandemic, the infection outbreak management policy concentrated on infections, such as flu, gastroenteritis, diarrhoea and vomiting and did not refer specifically to COVID-19.” from the report
Agency staff records
minorAt the visit, the home did not yet have confirmation that agency staff had been vaccinated as required by the guidance. Confirmation was received after the inspection.
“the registered manager had not received confirmation to demonstrate agency staff had been vaccinated in accordance with current government guidance.” from the report
- 01What changes were made to the infection outbreak policy after the inspection?
- 02How do you now check and record COVID-19 vaccination or exemption evidence for agency staff?
- 03What happens to visiting if there is another COVID-19 outbreak, including for people receiving end of life care?
- 04How do you monitor staffing pressures linked to COVID-19 and their effect on care?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not provide ratings for the home's other areas of care. This explanation was written from the published report of 22 March 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 2020
The Grange was rated Good; inspectors found safe, kind and personalised care, with some improvements still needed to support independence and people living with dementia.
This was an unannounced planned inspection over two days. One inspector spoke with staff and relatives, reviewed care and medicines records, checked other records, and observed care and mealtimes.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, kind interactions, personalised care and effective management.
There were some less positive findings. Cleaning records were not always completed, some people needed better support to be independent at mealtimes, and more could be done to meet the needs of people living with dementia.
The previous rating was Requires Improvement after an inspection on 14 January 2019, with a breach about recruitment checks. Improvements had been made and the home was no longer in breach.
Safe staffing and recruitment
Inspectors found enough staff and said the provider had completed the necessary employment checks. This was an improvement from the previous inspection.
“All necessary pre-employment checks had been completed which helped ensure staff were suitable to work with vulnerable people.” from the report
Kind and respectful care
Staff were observed having positive, kind interactions with people. Inspectors found that privacy, dignity and communication needs were supported.
“We observed kind and caring interactions throughout the inspection.” from the report
Personalised support
Care plans reflected people's needs and preferences and were reviewed when circumstances changed. Relatives said staff understood how their family members preferred to do things.
“People received personalised care which reflected their needs and preferences; from staff who were committed to providing person-centred care.” from the report
Strong management oversight
The manager used audits and other checks to monitor care, records and the building. The provider and manager had also acted on the previous inspection findings.
“The provider and registered manager followed clear and robust governance systems which helped ensure they had an effective oversight of the service.” from the report
Cleaning records
minorNot every cleaning checklist had been completed. The manager dealt with this during the inspection, but families may want to check how this is now monitored.
“Not all cleaning records had been completed, the registered manager addressed this during the inspection to ensure records were maintained.” from the report
Independence at mealtimes
needs fixingSome people had to wait for staff to offer condiments, and some would have benefited from equipment or arrangements that helped them eat more independently.
“We found more could have been done to support people to be independent at meal times.” from the report
Environment for people living with dementia
needs fixingInspectors said the home had not done enough to meet the needs of people living with dementia. The manager was aware and had improvements planned.
“Not enough had been done to meet the needs of people living with dementia.” from the report
- 01What changes have been made to help people living with dementia, and which improvements are still planned?
- 02How do you help residents serve themselves and use suitable aids during meals?
- 03How are cleaning checklists completed, checked and followed up now?
- 04How do you make sure staffing levels remain sufficient when residents' needs change?
- 05How are care plans reviewed with residents and their relatives when needs or preferences change?
This was an unannounced planned inspection covering all five CQC questions, with care and accommodation both looked at. This explanation was written from the published report of 9 April 2020 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
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- March 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- April 2020Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018
Registered with the Care Quality Commission on 3 August 2018.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.