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Inspection Summary


Overall summary & rating

Good

Updated 9 October 2018

The Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It is registered to provide accommodation for up to 27 people, some of whom have a dementia related condition. There were 26 people using the service at the time of the inspection. The Grange also provides a day care service. We did not inspect this part of the service because it was outside of the scope of our regulations.

At our last inspection in June 2017, we found one continuing breach of the Health and Social Care Act 2008. This related to good governance. We rated the service as requires improvement and issued a warning notice. Some of the concerns and shortfalls related to the homecare service which was registered together with the care home service. In January 2018, the provider registered the homecare service separately.

At this inspection, we found that improvements had been made and the provider was no longer in breach of the regulations.

The previous registered manager was now the operations manager and oversaw the management of the Grange and the provider’s other two services. The manager designate [in waiting] at our last inspection was now the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

An effective system was now in place to ensure the safety of the premises and equipment. Key pads and a sensor had been fitted to the main staircase to reduce the risk of falls on the stairs. The home was clean and there were no malodours in any of the areas we visited. A new washer disinfector had been installed for the cleaning of continence equipment. People's individual needs were met by the adaptation, design and decoration of premises. The home had been a vicarage and had a homely feel.

Medicines were managed safely. The home had limited storage areas. The registered manager’s office was used to store medicines. Staff made the best of the facilities available. Medicines were safely locked away in a trolley and lockable cabinets.

Staff assessed the risks relating to people to safeguard their health, safety and welfare. Accidents and incidents were analysed to help identify any trends to ensure action was taken to reduce any reoccurrence. There were enough staff deployed to meet people’s needs. Safe recruitment procedures were followed.

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

Staff received appropriate training to meet people’s needs. There was a supervision and appraisal system was in place to make sure staff were supported.

People’s nutritional and hydration needs were met. There was an emphasis on home baking and fresh produce was purchased from local suppliers to help support the local community.

People and relatives told us that staff were caring. Staff displayed warmth when interacting with people. Person centred care plans were in place which helped staff deliver care which met people’s personal preferences.

Two activities coordinators were employed to help meet people’s social needs. A varied activities programme was in place.

There was a complaints procedure in place. There was one ongoing complaint which had been sent to the local authority and not to the home directly. The complaint was being independently investigated on behalf of the local authority. None of the people and relatives with whom we spoke raised any complaints.

An effective system was now in place to monitor the quality

Inspection areas

Safe

Good

Updated 9 October 2018

The service was safe.

Action had been taken to improve following our previous inspection. An effective system was now in place to ensure the safety of the premises and equipment and assess the risks relating to people to safeguard their health, safety and welfare.

Medicines were managed safely.

There were enough staff deployed to meet people�s needs. Safe recruitment procedures were followed.

Effective

Good

Updated 9 October 2018

The service was effective.

Action had been taken to improve following our previous inspection. Staff followed the principles of the Mental Capacity Act 2005.

People�s nutritional and hydration needs were met.

Staff received appropriate training to meet people�s needs. There was a supervision and appraisal system in place to make sure staff were supported.

Caring

Good

Updated 9 October 2018

The service was caring.

People and relatives told us that staff were caring. Staff displayed warmth when interacting with people.

Person centred care plans were in place which gave details of people�s likes and dislikes. These helped staff deliver care which met people�s personal preferences.

People�s privacy and dignity was promoted.

Responsive

Good

Updated 9 October 2018

The service was responsive.

Action had been taken to improve following our previous inspection.

People�s care plans supported staff to provide person centred care which helped ensure people received care that was responsive to their needs.

Two activities coordinators were employed to help meet people�s social needs. A varied activities programme was in place.

There was a complaints procedure in place. There was one ongoing complaint. People and relatives with whom we spoke did not raise any complaints.

Well-led

Good

Updated 9 October 2018

The service well led.

Action had been taken to improve following our previous inspection. An effective system was now in place to monitor the quality and safety of the service.

People, relatives and staff were involved in the running of the service. Meetings and surveys were carried out.

Staff told us they enjoyed working at the home. We observed that this positivity was reflected in the care and support which staff provided throughout the day.