You are here

The Grange Care Centre Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 December 2018

We undertook an unannounced inspection of The Grange Care Centre on 4, 5 and 6 September 2018.

The Grange Care Centre 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. The Grange Care Centre can provide accommodation and nursing care for up to 160 people with general nursing needs and end of life care. The service had eight separate units, each of which have individual bedrooms with en-suite facilities and communal living, dining, bath, shower and toilet facilities. Support was provided for older people including those with dementia care needs, younger adults with a physical disability and/or mental health needs and people requiring care at the end of their lives. At the time of the inspection there were 151 people living at the care home.

We previously inspected The Grange Care Centre on 30 and 31 August 2017 and 4 September 2017 and we identified three breaches of regulations. These were in relation to person-centred care, safe care and treatment of people using the service and good governance. The provider was rated requires improvement in the key questions of Safe, Responsive and Well-led and overall. We carried out a focused inspection of the service on 5, 6 and 9 February 2018 and we reviewed the key questions of Safe, Responsive and Well-led. We found improvements in relation to person centred care. We found the continuing breaches of two regulations in relation to good governance and staffing. At this inspection, the rating for the service remains requires improvement. This means the provider has been rated as requires improvement since the August 2017 inspection.

Following the last inspection, we asked the provider to complete an action plan to show when they would meet the regulation. The provider’s action plan stated they would be meet the regulation by 2 July 2018.

At the time of the inspection there was a registered manager in post who has been at the home since August 2014. 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 2008 and associated Regulations about how the service is run.

We found some improvements had been made to the way care staff were deployed to support people around the home but feedback we received, from both people using the service and care staff, identified they felt that at times there were not enough care staff deployed to care for people. We have made a recommendation about the deployment of care staff.

The provider had a medicines procedure in place which was followed by care staff in relation to the storage, administration and recording of medicines but we noted some care staff were not aware of how to safely handle cytotoxic medicines. We have made a recommendation regarding guidance on handling these medicines.

Records relating to people using the service did not always provide accurate information relating to the care and support they needed, so staff had all the information they needed to care for people

The provider had audits in place, but these did not always identify areas where improvement was required and where they had identified areas for improvement, action taken was not always effective in securing the necessary improvements.

People told us they felt safe when receiving care and the provider had procedures developed to respond to any concerns relating to the care provided.

Incidents and accidents were reviewed and the provider took action where required and provided guidance to staff to reduce a possible reoccurrence. Risk management plans had been developed providing care staff with information as to how to reduce possible risks.

There wa

Inspection areas

Safe

Requires improvement

Updated 12 December 2018

Some aspects of the service were not safe.

The provider had a policy in place for the administration of medicines which was followed by care staff but we have made a recommendation in relation to the handling of cytotoxic medicines.

Some improvements have been made in the way care staff were deployed but issues were still identified by people using the service and care staff. We have made a recommendation in relation to care staff deployment.

People told us they felt safe when receiving care. Risk management plans were in place providing guidance for care staff on how to minimise risks for people using the service.

Effective

Good

Updated 12 December 2018

The service was effective.

Assessment of people’s support needs were carried out before the person moved into the home.

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

Care staff received the training and supervision they required to provide them with the knowledge and skills to provide care in a safe and effective way.

People were supported to eat healthy meals that met their dietary, cultural and religious needs.

People had access to a GP and other healthcare professionals.

Caring

Good

Updated 12 December 2018

The service was caring.

People were supported with their cultural and spiritual needs.

Care staff supported people in a kind and caring manner, with positive and respectful interactions with people using the service and relatives.

Responsive

Requires improvement

Updated 12 December 2018

Some aspects of the service were not responsive.

People’s care plans were not written in a way that identified the person’s wishes as to how they wanted their care provided. Records did not provide up to date information relating to people’s care.

People using the service could access a range of activities organised by care staff.

The provider had a complaints process and people were aware of how to raise concerns.

Well-led

Requires improvement

Updated 12 December 2018

Some aspects of the service were not well-led.

The provider had audits and other checks in place but these were not always effective in identifying areas where improvement was required or securing the necessary improvements.

People using the service and staff felt the service was well-led.