CQC report explained · a residential care home
What the CQC found at The Grange
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with medicines storage and stock control, waste handling, infection control and records about safety incidents. They also found enough staff, safe recruitment and staff who understood safeguarding.
- Effective?
- Good
- This question was not assessed during this focused inspection.
- Caring?
- Good
- This question was not assessed during this focused inspection.
- Responsive?
- Good
- This question was not assessed during this focused inspection.
- Well-led?
- Requires improvement
- Management systems did not reliably monitor quality, risks or regulatory records. People and relatives' views were not gathered regularly, although staff said they felt supported and could raise concerns.
What inspectors found, October 2023
The Grange rated Requires Improvement; inspectors found weaknesses in medicines, infection control and management oversight, although staffing and people's sense of safety were positive.
This was an unannounced focused inspection on 13 September 2023. Inspectors looked at Safe and Well-led, including infection prevention and control. They spoke with people, relatives and staff, and reviewed care and management records.
The home had problems with medicines storage and stock checks. Soiled laundry and clinical waste were not always handled promptly or correctly. Records about accidents, safeguarding concerns and notifications to the CQC did not match, and the home was not showing enough evidence that it learned from incidents.
People said they felt safe. Inspectors found enough staff, safe recruitment and staff who understood safeguarding. Staff administering medicines were trained and competent. However, the overall rating fell from Good at the previous inspection to Requires Improvement because safety and management systems were not reliable enough.
Enough staff
Inspectors found enough suitable staff to meet people's needs. Care was provided calmly and without rushing.
“There were sufficient numbers of suitable staff to support people's care needs.” from the report
Staff understood safeguarding
Staff knew how to recognise and report possible abuse. People told inspectors they felt safe.
“Staff were knowledgeable about how to report abuse and how to identify possible safeguarding concerns.” from the report
Safe recruitment
The home carried out checks before employing staff to help ensure they were suitable to work with vulnerable people.
“The service undertook a range of checks to seek assurance that potential employees were safe to work with vulnerable people.” from the report
Working with professionals
The home worked with health professionals involved in people's care, including GPs, district nurses and physiotherapists.
“The service worked closely with health professionals such as GPs, District Nurses, and physiotherapists.” from the report
Medicines controls
seriousMedicines were not always stored, checked or disposed of safely. Inspectors found no temperature monitoring for the medicines room and inconsistent stock control.
“The service did not always follow relevant national guidelines around storing medicines and disposing of them.” from the report
Poor learning from incidents
seriousThe home did not consistently investigate accidents, falls and near misses or record improvements. This meant repeated risks might not be properly addressed.
“There was no evidence of an overarching view of these.” from the report
Inconsistent safety records
seriousRecords about accidents, safeguarding concerns and matters reported to the local authority and CQC did not match. An earlier recommendation about safeguarding reporting had not led to improvement.
“At this inspection we found discrepancies between the provider's recording systems in relation to safeguarding concerns, concerns reported to the Local Authority, and those reported to the Care Quality Commission.” from the report
Infection control gaps
needs fixingInspectors were not assured that the home was helping people minimise infection spread or that hygiene and premises layout were promoting safety. Records for cleaning, PPE and laundry checks were also incomplete.
“We were not assured that the provider was supporting people living at the service to minimise the spread of infection.” from the report
Limited feedback
needs fixingPeople and relatives' views had not been gathered regularly, and questionnaires were not formally analysed. The provider was asked to review its feedback arrangements.
“Although a management feedback check had taken place, it was not evident that people or relatives' views had been sought since our last inspection visit.” from the report
- 01What checks are now made on medicines-room temperature, medicine stock and medicines awaiting disposal?
- 02How do you review repeated falls, accidents and near misses, and how do you record the changes made?
- 03How are safeguarding concerns recorded and checked against reports sent to the local authority and CQC?
- 04What has changed in cleaning, PPE and laundry checks since the inspection?
- 05How will you regularly collect and analyse feedback from people and relatives?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive were not assessed in this visit. This explanation was written from the published report of 21 October 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, October 2022
The Grange rated Good; inspectors found safe, person-centred care but safeguarding reporting and some infection controls needed improvement.
Inspectors visited unannounced on 4 October 2022. They spoke with people living at the home, relatives, staff and professionals. They also checked care files, medicines records, recruitment records, training and quality checks.
The home was rated Good overall. Safe and Well-led were both rated Good. People said they felt safe, medicines were managed safely, staffing levels were suitable and risks to people were assessed and reviewed.
There were some weaknesses. Safeguarding concerns were not always reported properly or quickly enough, so inspectors recommended a review of the reporting system. Some staff did not wear masks correctly and some cleaning schedules were incomplete, although these issues were addressed or being addressed during the inspection.
Suitable staffing
Inspectors found there were enough staff to provide safe care. Recruitment checks were in place to help ensure suitable people were employed.
“There was enough staff to ensure people received safe care.” from the report
Safe medicines support
People received their medicines as prescribed. Instructions and updated risk assessments helped staff manage medicines safely.
“People's medicines were managed safely.” from the report
Positive culture
The home had a person-centred and open culture. People and staff said managers and staff were approachable and supportive.
“The service had an open, honest culture.” from the report
Quality monitoring
Managers carried out checks and audits, and used action plans when issues were found.
“There were effective quality assurance systems in place to monitor quality performance and ensure good governance.” from the report
Safeguarding reporting
needs fixingSafeguarding procedures were not fully embedded. Concerns were not always reported appropriately or quickly enough, and inspectors recommended that the provider review its systems.
“Safeguarding concerns had not always been reported appropriately.” from the report
Infection control records and PPE
needs fixingSome staff did not wear masks correctly and some cleaning schedules were incomplete. The mask issue was corrected during the inspection, and a housekeeper had been employed to improve recording.
“Some cleaning schedules had not been completed, however the provider had now employed a housekeeper to ensure all hygiene practices were correctly recorded.” from the report
- 01What changes have been made to ensure every safeguarding concern is reported and acted on quickly?
- 02How do managers check that staff wear masks correctly when required?
- 03How are cleaning schedules now completed and checked?
- 04How are people and relatives' views used to make improvements?
- 05Which ratings from the previous inspection were carried forward rather than checked during this visit?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 29 October 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 Grange
3 rated inspections over a year: the service has slipped, from Good to Requires improvement.
- October 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2022Goodstayed GoodSafe: GoodWell-led: Good
- May 2022GoodSafe: GoodWell-led: Good
- December 2020Inspected but not ratedSafe: Inspected but not rated
- November 2020
Registered with the Care Quality Commission on 13 November 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.
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
32 live-in carers within about an hour of North Lincolnshire
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 £1,300 a week. 29 can care for a couple. 11 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
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.