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The Grange Nursing Home Good

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Inspection report

Date of Inspection: 11 July 2014
Date of Publication: 6 September 2014
Inspection Report published 06 September 2014 PDF

Overview

Inspection carried out on 11 July 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you wish to see the evidence that supports our summary please read the full report.

Is the service safe?

People who use the service were cared for in a safe and clean environment. Domestic staff cleaned daily and during our visit we saw people's rooms and the communal areas were clean. Equipment used had been well maintained and regular maintenance checks were performed which ensured equipment was fit for purpose. There were enough staff to meet the needs of people and the manager used the "safer guidance for nursing homes" staffing tool when planning staffing requirements. Gaps within the rota for registered nurses were filled by care workers which ensured enough staff were available and the registered manager was available to provide nursing assistance and advice as necessary.

Staff's personal records showed that the majority of staff had completed mandatory training in line with the home's policy, and staff were able to demonstrate their knowledge of safe care of people.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications had needed to be submitted, however proper procedures were in place and staff were able to demonstrate knowledge of the procedures when asked.

Is the service effective?

People told us they were happy with the care they received and felt the staff met their needs. One person told us "they look after me well" and are "really excellent". The care plans we reviewed contained detailed assessments of people's needs and the people we spoke with told us they were involved with planning their care. Staff told us they "get to know residents well" which they felt enabled them to meet their needs. Staff that at the home had completed national vocational qualifications (NVQ) in support of their work. Care plans we reviewed demonstrated where care workers had high-lighted changes in people's care needs, for example: a person complained of knee pain and action had been implemented by referral to the GP services and a review plan had been put in place. This meant the care staff were effectively meeting the changing needs of people who use the service.

The manager told us about their re-enablement facilities. People requiring short term rehabilitation with a view to returning to their own home used this service. One of two re-enablement rooms were being used during our visit. The manager told us a person that had been recently admitted to this facility had been unable to return home due to a high incidence of falls. As a direct result of assessments completed at the home they had been moved to alternative nursing accommodation.

Is the service caring?

People were supported by staff who were kind and caring. We observed staff knocking on doors and asking politely when care tasks were required, which meant they cared about respecting people's privacy and dignity. People told us they were supported to do things in their own time and chose when they wanted to do things such as: activities and the time they went to bed. One person told us " I prefer to be alone" but the "staff would take me downstairs if I wanted to go". A visitor that we spoke with told us "we are a family" and felt the staff were approachable and accommodated individual needs.

We observed staff speaking with people and saw they asked " how are you?" and saw they gave people time to move freely at their own pace around the home. During mealtimes we saw they spoke kindly to people and checked they had eaten and drank enough.

Is the service responsive?

People's needs were assessed before moving to the home and reviewed on a monthly basis. Activities were provided daily and people were encouraged to take part and chose what they wanted to do. The activities coordinator told us if people wanted to change the daily activities then they were supported to do so. Visitors were encouraged at the home and staff always checked with people that they were happy for their visitors to come in.

Is the service well led?

Regular resident and staff meetings were held and people were involved in decisions about the home. During our visit we were told about a planned extension to the home and people said they were consulted about the plans during the resident's meetings. Drawings and information about the extension were displayed in the main hallway. Staff told us they felt involved in the running of the home and the manager kept them informed of any changes.

We reviewed the last residents satisfaction survey conducted in April 2014 and saw that actions had been put in place to address negative comments including signage to remind people to close doors quietly. The majority of comments were positive and people stated they were "happy" living at the home.

There were two complaints made to the manager in 2014 and people told us they had "no complaints" about the home. They said they understood the complaints process.