CQC report explained · a residential care home
What the CQC found at The Grange Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2022
The Grange Residential Care Home is rated Requires Improvement; inspectors found kind, personalised care, but safety and management systems did not reliably identify risks.
This was an unannounced inspection on 22 September 2022. Inspectors spoke with people living at the home, relatives and staff. They reviewed care records, medicine records, recruitment files and management documents.
The home provided care for up to 36 people, and 36 people were living there at the time. Inspectors found good care in the effective, caring and responsive areas. Staff were described as kind, knowledgeable and respectful, and medicines were managed safely.
The main problems were fire safety, unsafe storage of hazardous substances and inconsistent infection control. The home’s checks had not found these problems. The overall rating fell from Good to Requires Improvement. Safe and well-led were both rated Requires Improvement, meaning there was limited assurance about safety and increased risk that people could be harmed.
Kind and respectful staff
People and relatives consistently spoke positively about staff. Inspectors saw respectful interactions that took account of people’s hearing and sight needs.
“People were supported by kind and caring staff.” from the report
Personalised care
Care plans included people’s preferences, communication needs and ways of moving safely. People and relatives were involved in planning care.
“People's care plans included their preferences which staff understood and followed.” from the report
Medicines managed safely
There were systems for ordering, storing and checking medicines. People received their medicines as prescribed, and staff administering them were trained and assessed as competent.
“People received their medicines as prescribed.” from the report
Enough staff
The home used a dependency tool to assess staffing needs. Inspectors found that rotas reflected the number of staff needed to care for people.
“There were enough staff deployed to meet people's needs.” from the report
Good access to activities and relationships
People were supported to keep in touch with family and friends and to take part in activities linked to their interests.
“People were supported to maintain regular contact with their family and friends.” from the report
Fire safety risks
seriousSome bedroom doors were regularly propped open, and an outdoor bench was being used as a barrier near a fire exit. Inspectors said these arrangements could put people at risk during a fire.
“People were at risk of not being able to safely exit the home in the event of a fire.” from the report
Hazardous items not always secured
seriousHand sanitiser had no risk assessment, cleaning chemicals were in an unlocked cupboard and alcohol was found in another unlocked cupboard. These items could have been ingested or touched by people.
“The cupboard where cleaning chemicals were kept was found to be unlocked; a bottle of alcohol was found in an unlocked cupboard in the dining room.” from the report
Inconsistent infection control
seriousSome areas were not clean, cleaning records were incomplete and equipment was rusty or dirty. Inspectors also found problems with the availability and type of waste bins for protective equipment.
“The standard of hygiene was inconsistent throughout the home, some personal and communal areas were found to be of a poor standard of cleanliness.” from the report
Management checks missed problems
needs fixingAudits and other checks had not identified the fire safety, hazardous substance and infection control issues found during the inspection. Feedback questionnaires had also not been reviewed to identify improvements.
“Governance and performance management was not always reliable and effective.” from the report
Some areas needed improvement
minorSome communal areas needed redecoration, and there was no signage to help people find their way around. Access to the garden required support because of security restrictions.
“Whilst some areas of the home, such as the lounge, had been redecorated, other communal areas required redecoration.” from the report
- 01What checks are now in place to make sure bedroom doors and fire exits are safe?
- 02How are cleaning chemicals, alcohol and hand sanitiser now stored and risk assessed?
- 03How do you check that cleaning schedules, equipment checks and infection control records are completed?
- 04What evidence can you show that the problems found in September 2022 have been fixed and kept fixed?
- 05How do you review feedback from people and relatives, and what changes have resulted from it?
This was an unannounced inspection covering all five key questions; the previous overall rating was Good, but Safe and Well-led were rated Requires Improvement at this inspection. This explanation was written from the published report of 25 November 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, January 2021
Rated Good overall; inspectors found safe care, but leadership and COVID-19 governance still required improvement.
The inspection took place during a confirmed COVID-19 outbreak. Inspectors visited on 13 November and 2 December 2020, spoke with people, relatives, staff and a health professional, and reviewed care plans, medicine records, staff files and quality checks.
The home was rated Good for Safe. Inspectors found enough safely recruited staff, suitable safeguarding training, safe medicines management and suitable risk assessments. They also found that infection control arrangements had improved by the second visit, including safer entry procedures and staff break areas.
The home was rated Requires Improvement for Well-led. Policies, cleaning arrangements and audits did not always reflect current COVID-19 guidance or identify needed improvements. The overall rating remained Good, but the inspection only directly assessed Safe and Well-led. Ratings for the other areas were carried forward from the previous comprehensive inspection.
Safe staffing
Inspectors found enough staff to support people and saw a good staff presence. Recruitment checks and training were in place.
“There were sufficient staff to support the service.” from the report
Safeguarding
People were protected from abuse, and staff understood what to do if abuse was suspected.
“People were protected from the risk of abuse.” from the report
Medicines
Medicines were stored and managed safely. The medicine records inspected were complete.
“We reviewed the medicines administration records for four people and found they had been fully completed.” from the report
Kind, person-centred care
People and relatives said they felt safe and cared for. Inspectors saw kind, caring and person-centred support.
“People told us staff were kind and caring, this was observed during the inspection.” from the report
COVID-19 guidance was not kept up to date
needs fixingAt the first visit, some infection control arrangements did not meet current government guidance. Although some changes were made by the second visit, the policy still did not refer to current guidance.
“The provider had not ensured staff were guided to understand and work within up to date guidelines for COVID-19.” from the report
Weak provider oversight
needs fixingThe provider had introduced audits, but these did not identify important improvements that were needed. The home also did not keep an ongoing record showing that policy updates had been shared with staff.
“At this inspection we found provider audits had been introduced, however, we found these had not identified where improvements were required.” from the report
- 01How do you now make sure COVID-19 guidance, infection control policies and cleaning schedules are kept up to date?
- 02How do you record that changes to policies and procedures have been shared with every member of staff?
- 03What checks does the provider now carry out to make sure audits identify and fix problems?
- 04What changes were made after the concerns found during the first visit on 13 November 2020?
- 05How do you make sure lessons from infection outbreaks and changes in guidance are acted on?
This was a targeted infection control inspection followed by a focused inspection of Safe and Well-led; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 21 January 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 Residential Care Home
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Grange Residential Care Home →
- January 2021Goodstayed GoodSafe: GoodWell-led: Requires improvement
Read what inspectors found at The Grange Residential Care Home →
- October 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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