The Grange Residential Hotel

Updated 12 December 2018

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one adult social care inspector and one assistant inspector.

Service and service type

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.

The service accommodates 17 people in one adapted building. It also has a separate supported living service on site. Seven people were using the supported living service at the time of our inspection, none of them required support with personal care. Therefore, we did not include this as part of our inspection.

There was a registered manager in post. 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.

Notice of inspection

This inspection was unannounced.

What we did:

Before the inspection we gathered and reviewed the information we held on the service such as notifications, where the provider tells us of any significant events, and previous inspection reports. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We observed the lunchtime meal and conducted a SOFI in the communal lounge. A SOFI is a tool for observing interactions between care staff and people who may not be able to communicate with us verbally. This gives us an idea of what their care experience might be like for the time that we are there.

We spoke with six people using the service, six care staff, the chef, housekeeping staff, one volunteer, the operations and facilities manager and the registered manager.

We had feedback from three health professionals who worked with the home, and five relatives.

We reviewed four peoples care records including risk assessments, care plans, consent documents and daily and nightly notes. We also looked at policies and procedures and records relating to fire, health and safety, complaints, incidents, and lessons learned. We examined Medicine Administration Records (MAR) for eight people and five staff recruitment files.

We walked through the building and checked every upstairs room and the safety of their windows.

Updated 12 December 2018

What life is like for people using this service:

• Every person we spoke with fed back that staff were caring and they were happy living in the service. Relatives told us the service felt like a home and they were made to feel welcome when they visited their loved ones.

• Bedrooms were personalised and people had their photographs on display, there was the smell of home cooked food and baking throughout the building. Some building improvements needed to be made to modernise the facilities but the provider had already planned these.

• Staff felt supported and had received enough training to enable them to support people in line with best practise guidance. Staff told us they enjoyed their jobs and had a good understanding of person centred care.

• People were offered choices in their day, the registered manager had good knowledge of the Mental Capacity Act 2005 (MCA).

• There had been several improvements introduced since our last inspection. Records were more accurate and contained more detailed risk information for specific health conditions.

• The quality of the care was regularly audited and care improved as a result. Issues were followed up with staff and relatives and people were encouraged to feed back to the registered manager.

• People’s health needs were met with referrals to health professionals where needed. Regular contact was had with the district nurse and GP, both of whom gave positive feedback about the service.

• Medicines were managed safely and administered calmly. Recording was accurate.

• Activities were daily and offered a range of different things to do but these were not always to people’s tastes. Improvements to the activities offered were underway at the time of our inspection.

More information is available in the detailed findings sections below.

Rating at last inspection: Requires Improvement (report published 23 November 2017)

About the service: The Grange Residential Hotel (hereafter referred to as The Grange or the service) is a residential care home that was providing personal and nursing care to 14 people aged 65 and over at the time of the inspection. The service is in an adapted period property in the village of Ipplepen in Devon.

Why we inspected: This was a planned inspection based on the last rating. This service is a service that has been rated requires improvement in two out of three previous inspections.