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 avoidable harm. Inspectors found improved infection control, detailed risk assessments, enough staff, safe recruitment, appropriate incident management and safe medicines systems.
- Effective?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Good
- Inspectors found approachable management, regular audits, action plans, staff competency checks and good involvement of people, relatives and staff.
What inspectors found, June 2021
The Grange is rated Good; inspectors found safe, caring support and major improvements since the previous inspection.
This was an unannounced focused inspection on 25 May 2021. Inspectors checked Safe and Well-led, including infection control, staffing, medicines, care records, incidents and management systems. They spoke with people, relatives, staff and a visiting professional, and reviewed records.
The home was rated Good overall, Good for Safe and Good for Well-led. Inspectors found that infection control had greatly improved. Staff used protective equipment properly, visitors were screened, the environment was safer and cleaner, and medicines were managed safely.
Care plans and risk assessments were detailed and reviewed regularly. There were enough staff, staff recruitment checks were completed, and lessons from accidents and incidents were shared. Managers used audits and action plans to identify and make improvements.
Improved infection control
The home had made major improvements to infection prevention. Staff used protective equipment safely and visitors were screened.
“We were assured that the provider was using PPE effectively and safely.” from the report
Detailed care planning
Care plans and risk assessments gave staff clear, individual guidance. They were reviewed monthly or sooner when needed.
“People's care plans contained detailed and person-centred information to enable staff to support them safely.” from the report
Enough trained staff
Inspectors found enough staff on duty and saw evidence of further training after the previous inspection.
“There were enough staff on duty to safely and effectively support people's needs.” from the report
Active quality checks
The management team used audits and action plans to find problems and track improvements.
“Regular audits were completed along with staff competency checks.” from the report
Maintenance still ongoing
minorThe environment had improved, but some maintenance work was still in progress. The home had an action plan for this.
“Maintenance work was ongoing and a clear action plan was in place.” from the report
- 01What maintenance work from the action plan is still outstanding, and when will it be completed?
- 02How do you assess and monitor people admitted urgently or in an emergency?
- 03How do you check that staff keep their infection control and other required training up to date?
- 04How are accidents and incidents reviewed, and how are lessons shared with all staff?
- 05How can people and relatives give feedback, and what recent changes have been made because of it?
This was a focused inspection of Safe and Well-led, including infection control; the other three question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 23 June 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.
What inspectors found, February 2021
Rated Inadequate for safety and Requires Improvement overall; inspectors found serious infection control, staffing and management problems.
This inspection began as a targeted check of infection prevention and control during the COVID-19 pandemic. Concerns about masks, visitors and other infection controls led to a wider focused inspection of safety and leadership.
Inspectors found that staff did not always use protective equipment correctly. The home did not always isolate people on admission, record incidents or learn from them. Some staff lacked up-to-date training, and parts of the building were not well maintained.
People said they felt safe and received good care. Medicines were mostly administered and stored safely, and relatives were happy with communication. However, the overall rating was Requires Improvement, with Safe rated Inadequate and Well-led rated Requires Improvement.
The previous overall rating was Good, published in February 2020. The safety and leadership ratings had both deteriorated. The provider was asked for an action plan, and CQC said it would monitor progress and re-inspect.
People felt safe
People spoken to told inspectors they felt safe and received good care.
“People told us they felt safe living at the home and received good care.” from the report
Medicines
Most medicines were administered and stored safely. Staff who administered medicines had training and yearly competency checks.
“Appropriate arrangements were in place for the safe administration and storage of most medicines.” from the report
Recruitment
The provider had suitable recruitment checks in place, including identity and security checks.
“The provider had an effective and robust recruitment procedure in place.” from the report
Communication
Relatives told inspectors they were happy with communication from the home.
“One relative told us that the home would, "Ring straight away if there are any updates.” from the report
Infection control
seriousStaff did not always use suitable PPE or follow infection control guidance. Visitors were not screened properly, social distancing was inconsistent and people were not isolated on admission.
“Staff did not always follow best practice guidance to manage the risks of cross infection.” from the report
Staff training
seriousSome staff lacked current training in PPE, infection prevention and supporting people whose behaviour might challenge others. This increased the risk of harm.
“Staff were not appropriately trained and competent to meet people's needs.” from the report
Incident reporting
seriousIncidents were not always recorded, so the home could not properly analyse them or show that lessons had been learned.
“There was no evidence of lessons learned following incidents.” from the report
Building condition
seriousInspectors found damp, a damaged back door and damaged skirting boards, doors and door frames. Some areas were also difficult to keep clean.
“The safety of the building had not been maintained.” from the report
Admissions
needs fixingThe home accepted a person whose needs staff could not appropriately support, and care plans were not in place for that admission.
“The home had accepted the admission of a person whose needs could not be appropriately supported by the staff.” from the report
Quality monitoring
needs fixingAudits did not identify the problems found during inspection. The home also delayed notifying CQC about two incidents.
“Quality assurance audits had not identified the issues we had found during this inspection.” from the report
- 01What has changed since the inspection to make sure all staff use the correct PPE and follow infection control procedures?
- 02How do you check that staff have current training and competency in infection prevention and supporting people whose behaviour may challenge others?
- 03How are incidents now recorded, reported to CQC when required and reviewed for lessons learned?
- 04What repairs have been completed to address the damp, damaged back door, flooring and other building problems?
- 05How do you assess whether a new person’s needs can be safely supported before accepting an admission?
This began as a targeted infection prevention and control inspection and became a focused inspection of Safe and Well-led; the other key questions were not rated. This explanation was written from the published report of 4 February 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
4 rated inspections over 6 years: the service has held its Good rating throughout.
- June 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Requires improvementdown from GoodSafe: InadequateWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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47 live-in carers within about an hour of County Durham
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 £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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