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
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safe recruitment, suitable medicines systems, good hygiene and arrangements for managing risks.
- Effective?
- Good
- Staff had the training and skills needed to support people. The home supported nutrition, health appointments, legal decision-making and people's everyday choices.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were supported to make choices, use their private space and do things for themselves.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported with accessible information, family contact, hobbies, social activities and complaints.
- Well-led?
- Good
- The manager had introduced extra quality checks after the previous inspection. People, relatives and staff were involved in the service, and the home worked with other agencies.
What inspectors found, October 2019
Rated Good; inspectors found safe, kind and personalised care, with some parts of the accommodation still needing refurbishment.
The inspection took place on 10 October 2019. One inspector spoke with all five people living in the home, three care staff and managers. They also checked care records, medicines, recruitment, training, complaints and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training and good support with health care, food, activities and communication.
The home had improved since the previous inspection. Its earlier overall rating was Requires Improvement, with a breach about dignity and respect. At this inspection, the breach had been fixed and the home was no longer in breach of regulations.
Kind and respectful care
Inspectors found that staff spoke politely, respected privacy and encouraged people to be independent. Relatives were positive about the way staff understood the people they supported.
“I can't fault the service because the staff are genuinely kind.” from the report
Choice and independence
People were supported to choose what to wear, what to do each day and when to go to bed. They were also helped to build skills and take sensible everyday risks.
“The outcomes for people living in the service reflected the principles and values of Registering The Right Support by promoting choice and control, independence and inclusion.” from the report
Improved management
The home had added quality checks after the previous inspection. These covered dignity, independence, care, medicines, incidents, health and safety and the accommodation.
“At this inspection we found the registered manager had introduced additional quality checks in response to our concerns.” from the report
Some accommodation needed repair
minorMost of the accommodation was well decorated, but some areas needed attention. Refurbishment was taking place and the manager said this would continue.
“Parts of the service are a bit tatty but it's the care that counts and the owner is doing a lot of repairs at the moment.” from the report
- 01Which parts of the accommodation needed refurbishment at the inspection, and what work has now been completed?
- 02How will you support my relative to make everyday choices and develop greater independence?
- 03How will you communicate with my relative if they need information in an easy-read, picture-based or signed form?
- 04How are medicines checked, including any variable-dose or as-needed medicines?
- 05How will you keep me informed about important changes in my relative's care?
This was a planned inspection of the overall service and all five CQC questions, following the previous Requires Improvement rating. This explanation was written from the published report of 29 October 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.
What inspectors found, October 2018
Rated Requires Improvement; inspectors found safe and effective care, but respect, independence and management were not consistent.
This was an unannounced inspection on 28 August 2018. The inspector spoke with four people, observed care, and reviewed care plans, risk assessments, staff records and quality checks.
The home was rated Good for Safe, Effective and Responsive. Inspectors found improvements in risk management, safeguarding, staff training, medicines, healthcare support, activities and accessible information.
The home was rated Requires Improvement for Caring and Well-led. Staff were usually kind, but one staff member mocked a person and staff sometimes did tasks people could do themselves. Some records were not respectful, and maintenance problems had not been identified quickly enough.
The overall rating was Requires Improvement. This was the fourth time the home had received this overall rating. The provider had improved several areas since the previous inspection, but breached Regulation 10 because dignity, respect and independence were not consistently protected.
Improved safety systems
The home had introduced better monitoring of accidents and incidents. Risk assessments gave staff clearer guidance, and safeguarding procedures were followed.
“A new system for monitoring accidents and incidents had been introduced which was effective in alerting the provider to any patterns or trends” from the report
Safe medicines and staffing
Medicines were stored, given and checked safely. Inspectors also found enough staff to keep people safe and support planned activities.
“There was enough staff to meet people's needs.” from the report
Training and healthcare
Staff had received relevant training and were supported through supervision and appraisals. People were helped to access healthcare professionals when needed.
“People received support to manage their healthcare needs. Referrals had been made to relevant healthcare professionals when needed.” from the report
Activities and choice
People chose activities, trips and holiday plans. They were supported to work towards personal goals and greater independence.
“People were involved in choosing how they wanted to spend their time which included regular trips out.” from the report
Accessible communication
The home used pictures, photographs and short sentences to help people understand information and make choices.
“A care plan had been developed with each person using short sentences and pictures to help the person understand its content.” from the report
Respect was inconsistent
seriousOne staff member mocked a person during the inspection. The provider took immediate action, but inspectors said people could not always be assured of care with dignity and respect.
“The provider had failed to ensure that at all times, people were treated with dignity and respect” from the report
Independence was not always promoted
seriousStaff sometimes completed tasks that people could do themselves. Records also used the same task format for everyone and did not always show individual goals and achievements.
“There were instances when staff were not doing all that they could to promote people's independence.” from the report
Maintenance checks were incomplete
needs fixingInspectors found a cracked bath, a rusty commode frame and temporary radiator-cover repairs. A maintenance book was introduced so problems could be recorded and followed up.
“Some aspects of the environment required improvement but had not been identified so that they could be addressed in a timely manner.” from the report
Person-centred care not embedded
needs fixingTraining had taken place, but inspectors found that its principles were not yet followed consistently by the whole staff team.
“person-centred care, which involved treating people with dignity and promoting their independence had not been fully embedded in the culture of the service.” from the report
- 01How do you check that every staff member speaks to people respectfully, including when someone has difficulty communicating?
- 02How do you record and review each person's individual goals, skills and achievements?
- 03How do you make sure staff support people to complete tasks themselves rather than doing those tasks for them?
- 04What maintenance issues have been recorded since the new maintenance book was introduced, and how quickly were they fixed?
- 05How do you check that the training in person-centred care is being followed consistently by all staff?
This was an unannounced inspection looking at all five CQC questions, including whether improvements had been made since the previous inspection. This explanation was written from the published report of 11 October 2018 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
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2018Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 1 October 2010.
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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