The Grange Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. People who lived at the home and staff were able to raise concerns without fear of repercussions.

Accidents and incidents were appropriately reported and investigated, with the involvement of other agencies where necessary. Lessons were learned from investigations, and these were shared with staff, which helped to continually improve and embed good practice.

The provider worked with healthcare professionals to establish and maintain safe systems of care, in which safety was managed well. People received good continuity of care when they moved between different services.

If transitions between services were not managed well for people, the manager raised concerns on their behalf. For example, the manager had concerns about a person’s health when they were recently discharged from hospital back to the home. The manager had arranged to speak with the hospital’s Patient Advice and Liaison Service(PALS) to raise concerns about the person’s discharge.

Relatives told us their family members had been supported well when transitioning between services, including when they moved into the home. One relative said, “[Family member] is safe and comfortable and well looked after. She found the transfer from hospital to The Grange easy and soon settled in. I think she was relieved to be here.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff focused on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately with the relevant authorities.

Staff attended safeguarding training in their induction and regular refresher training thereafter. Staff were able to describe the potential signs of abuse and how they would report any concerns they had.

The provider worked with the local authority and other agencies to investigate when safeguarding concerns were raised. This included contributing to safeguarding enquiries and providing information when requested.

The provider worked with people to understand and manage any risks in their care. Staff provided care that was safe, supportive and enabled people to do the things that mattered to them.

Relatives told us staff managed any risks well, for example if people required hoisting when transferring. One relative said, “[Family member] isn’t mobile, so they have to hoist her if she is getting out of bed. There is never a problem, all the staff are very well trained.”

A satisfaction survey returned by a relative stated, ‘Staffing ratios are high and, during the day when we have visited, we can see that staff are observant and anticipate any likely events and intervene to keep residents safe.'

The provider detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home was safe and well-maintained. Staff carried out regular checks on the safety of the building and equipment. Any issues identified were addressed promptly.

Relatives told us the environment suited their family members’ needs and preferences. One relative said, “It is an older-style property – clean and fresh but comfortable.” Another relative told us, “It feels very homely. In the lounge there are pictures and ornaments just like [family member] would have at home.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People said staff were available when they needed them and our observations confirmed this. Relatives told us staffing levels were good. One relative said, “What sold it to me was the number of carers available to the residents. There are always carers about; they are very good, very approachable and friendly.” Another relative told us, “We always see plenty of staff; there seems to be a good ratio of staff to residents.”

The manager used a dependency tool to calculate the number of staff needed on each shift based on people’s needs. The manager reviewed the dependency tool regularly, including when people’s needs changed or a new admission was made. Extra staff were put on a shift if reviews, meetings, or training were taking place to ensure there were always enough staff available to support people.

Relatives highlighted the consistency of staffing as a strength of the home. They said this meant their family members were cared for by staff who were familiar to them and who understood their needs, likes, and dislikes. One relative told us, “They have a team of carers that [family member] knows really well. It’s very good because they have very few agency staff there, which means it is a stable staff team.” Another relative said, “What stands out is the consistency of staff. They rarely have agency staff, and that’s important for all of us.”

Staff were recruited safely. All staff had an induction when they started work and had access to the training they needed to carry out their roles. A member of staff who had recently joined the team told us they were working towards the Care Certificate, a nationally-recognised set of standards, knowledge, skills, and behaviours for care workers.

Each member of staff had a minimum of 4 supervision sessions a year, where they had the opportunity to discuss their performance, development and training needs with the manager.

The provider effectively assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared any concerns with appropriate agencies when necessary.

Staff received training in the prevention and control of infection and told us they had access to personal protective equipment (PPE) when they needed it. Cleaning schedules were in place to ensure good standards of hygiene were maintained in all parts of the home.

Relatives told us staff kept the home clean and hygienic. One relative said, “It’s always clean.” Another relative told us, "[Family member's] room is always spotless."

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Relatives told us staff kept them up to date about any changes to their family members’ medicines. One relative said, “They keep me informed about any changes to [family member’s] medicines; they call and let me know.”

There were appropriate arrangements for the ordering, storage, administration, and disposal of medicines. The medicines administration records we checked were accurate and up to date. There were guidelines in place for medicines prescribed ‘as and when required’ (PRN), and guidance for the administration of topical creams (those applied to the skin) was clearly documented. Regular audits were carried out to ensure medicines were being managed safely.