Grange House

Updated 1 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Grange House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Southlands Place is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We looked around the service and met with the people who lived there. We spoke with eight people to understand their views and experiences of the service and we observed how staff supported people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, a senior care staff member, and 5 other staff members.

We reviewed the care records of seven people and a range of other documents. For example, medicine records, staff training records and records relating to the management of the service. We also looked at staff rotas, and records relating to health and safety.

Following the site visits, we continued to seek clarification from the registered manager to validate evidence found. We spoke with four visitors and three health care professionals.

Updated 1 August 2023

About the service

Grange House is registered to provide care and accommodation for up to 17 people. There were 16 people living in the service when we visited. People who lived at Grange House were a mixture of younger and older people who were living with dementia, and/or a mental health disorder.

People’s experience of using this service and what we found

The provider’s governance systems had improved since the last inspection in September 2022 and systems were being used consistently to drive improvement within the service. The registered manager was pro-active and enthusiastic and committed to making improvements. Improvements had been made, however were still areas that needed to be further developed to ensure continued people's safety and well-being. For example, ensuring staff undertake specific training to meet individual needs such as catheter care.

A new care plan system had been introduced since the last inspection. It has been in place since June 2023, and this had had a positive impact on care delivery and safe outcomes for people. People had care plans and risk assessments which meant people’s safety and well-being was promoted and protected. The management of medicines had improved, and medicines were given safely to people by appropriately trained staff, who had been assessed as competent. Safe recruitment practices had been followed before staff started working at the service. There were enough staff to meet people's needs.

The home was clean, and comfortable, there were refurbishment plans in progress. Accidents and incidents were recorded, and lessons learnt to prevent re-occurrences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service had a pro-active management team which provided good leadership for staff and communicated effectively with people, relatives and professionals. One visitor said, “The manager communicates well and in a timely way,” and “Contact with the manager over any concerns was met with prompt action, nothing is too much trouble.” The management team was approachable and visible to people, staff, and visitors. Staff were positive about their roles and felt valued for the work they did.

The views of people who lived at the home, their relatives and staff were encouraged and acted upon by the management team. People and their relatives felt able to raise any concerns they had and were confident these would receive an appropriate response.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement, (4 November 2022) and there were breaches of regulation. The service remains rated requires improvement.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an comprehensive inspection of this service on 22 and 27 September 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, fit and proper persons employed, staffing and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contained the main elements of those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Grange House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.