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Inspection carried out on 30 November 2016

During a routine inspection

This inspection was unannounced and took place on 30 November 2016. The Grange Retirement Home provides accommodation, nursing and personal care for up to 62 people. There were 54 people living at the service at the time of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 last inspected the service on 16 December 2013. The service met all the regulations we checked at that time.

Staff knew how to keep people safe from abuse. Staff identified and managed risks to people’s health and safety. Incidents and accidents were monitored and staff took appropriate action to minimise recurrence.

There were robust recruitment practices in place and staff were suitable to work with people. There were sufficient numbers of staff to meet people’s needs. People received their medicines in line with the provider’s medicine management procedures. Medicines were managed and stored safely.

Staff had appropriate skills and knowledge to meet people’s needs. Staff were supported in their role and had received supervisions and an annual appraisal to monitor their work.

People received support in line with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People gave consent to care and support.

People were supported to eat and drink. People had a choice of food and drink and could choose where they had their meals. Staff sought and followed health care professional’s advice to support people with their dietary needs. People were supported to maintain their health and had access to healthcare professionals when needed.

People were happy with the care they received at the service. People were treated with kindness and compassion. Staff knew people well and respected their preferences on how they wanted to be supported. Staff respected people’s dignity and privacy. Staff promoted people to be as independent as possible. People received specialist care when nearing the end of their lives.

People’s needs were assessed and reviewed regularly. People and their relatives were involved in planning people’s care. Staff received guidance about how to support people. People were involved in planning their day to day care.

People received support to pursue their hobbies and interests. There were activities organised in which people could participate. The registered manager had put plans in place to ensure there were always sufficient or specific activities to meet people’s differing needs or preferences.

People and their relatives were asked their views of the service. The registered manager used their feedback to improve the quality of care. People knew how to raise a complaint. The registered manager investigated and resolved complaints in line with the provider’s procedure.

People, their relatives and staff described the registered manager as approachable. They were happy with how the service was run.

There were regular audits to review the quality of care and safety of the premises. The service worked in partnership with other healthcare professionals to ensure people received the support they required.

Inspection carried out on 16 December 2013

During an inspection to make sure that the improvements required had been made

We visited The Grange Retirement Home to check if they had become compliant with the compliance actions we made during our inspection in July 2013. We did not on this occasion have discussions with people who used the service or staff. We met with the registered manager and the clinical lead nurse during this visit.

Inspection carried out on 17, 19 July 2013

During a routine inspection

During our inspection visit we spoke with seven people who used the service, four relatives, seven members of staff and the registered manager.

People told us they liked living at the service; however. They told us that staff respected their privacy and dignity. One person told us, “Staff treat me with respect. They knock on my bedroom door and wait for me to answer.”

Most people told us they had a care plan that informed staff how they would like to be looked after. Other people told us their family members were more involved with their care plans. One person told us, “Staff look after me well here so I do not need to see a care plan.”

People told us staff had explained to them what their medication was for. They told us that nurses were good at making sure they received their medication on time.

People told us that there were plenty of staff on duty and they always attended to them when they needed them. People knew how to make a complaint. They showed us the complaints procedure they had in their bedrooms.

We found the service to be non-compliant with one of the seven outcomes we looked at.

Inspection carried out on 7, 21 December 2012 and 31 January 2013

During a routine inspection

During our inspection we spoke with five people and also gained the views of seven friends and relatives. We also spoke with eight members of staff. We made observations throughout the visit and we reviewed seven care plans related to individual people using the service.

We saw that staff were communicating with people respectfully and were giving encouragement at all times throughout the day. People we spoke with told us that they felt they were treated with dignity and respect and felt safe with staff. One person said "They are very good. They have a hard job to do." However we saw that people did not always have their privacy and independence respected particularly during mealtimes.

We saw that there was a small range of activities available and the people we spoke with all agreed that they had some kind of interaction. We spoke to a staff member who told us "We try to have something going on everyday but I wish we could offer more, like taking people out." We saw that staff were very caring and accommodating with people's request and one family member told us "I have never had cause to complain." However, we did see that people's changing needs were not always being monitored and assessed.

We saw that staff were trained to a high standard but there were not always enough qualified staff on duty. We also saw that risks were being identified within records but these were not always monitored to reflect a change in people's care needs.

Inspection carried out on 15 November 2011

During a routine inspection

All the people we spoke to appeared relaxed and engaged in conversations with visitors, table top activities and generally engaging with the one and other.

One person who had recently moved into the service said that they were “very happy there and thought all the staff are kind, considerate and caring”. Another person told us that the staff, “always show a cheerful and caring attitude to those in their care”.

A regular visitor “told us that the home is always open and accommodating and felt that the staff are caring and kind”.

One relative of a person living at the service said that they are “impressed with the staff resident ratio” and that it is “always pleasing to see so many staff being available”.

Reports under our old system of regulation (including those from before CQC was created)