The Grange

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 inspection we rated this key question inadequate. At this inspection the rating has changed to 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 service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to safety concerns and took appropriate action by investigating and reporting events. Lessons were learnt to continually identify and embed good practice. The registered manager shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through handovers, supervisions and staff meetings.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Before people came to live at the service the registered manager completed an assessment of their needs to ensure they could be met by the service. People and their relatives had an opportunity to visit the service before they moved in to see if it was a place they would like to live. The registered manager liaised with other healthcare professionals to ensure people’s healthcare needs continued to be supported.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.
Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people. This action included informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to local authority if I needed to.”
 

The service worked with people to understand and manage risks using a holistic approach. Staff provided care that was safe, supportive, and enabled people to do the things that mattered to them. Risks were clearly identified and appropriate safeguards put in place to mitigate them. For example, when people were at risk of experiencing falls, staff ensured appropriate equipment was in place and worked with individuals to reduce these risks. Staff also promoted preventative measures, such as encouraging people to remain well hydrated and nourished to reduce the risk of infections or skin breakdown. People were supported to live full lives, including safely accessing the community.
There was also clear guidance in place for staff to support people with specific health needs such as, diabetes. This included actions to take in the event of out-of-range high or low blood glucose levels, enabling staff to recognise changes in people’s conditions and respond appropriately to ensure safe and effective care.
Personal emergency evacuation plans (PEEPS) contained all the information staff, and the fire service may need to evacuate people safely in the event of a fire.
 

The service identified and managed potential risks within the care environment and ensured equipment, facilities and technology supported the delivery of safe care. The environment was adapted to meet the needs of people living there. There were communal areas which provided people with sufficient room to relax and take part in activities comfortably. People also had access to well-maintained outdoor spaces, allowing them to enjoy fresh air and time in the garden.
People’s bedrooms had recently been refurbished to improve comfort and quality of life.
Improvements had been made across the premises, including repairs, redecoration and the replacement or maintenance of fixtures and equipment. Bathrooms and shower areas had been upgraded and were clean, well-maintained and free from odours. Furniture and fittings were secure, and equipment, such as televisions, was in working order.
There was a clear focus on maintaining and continuously improving the environment. There were systems in place to ensure any maintenance needed was recorded and responded to promptly.
 

The service ensured there were sufficient numbers of qualified, skilled and experienced staff who received effective support, supervision and development. Staff worked collaboratively to deliver safe care that met people’s individual needs.
The registered manager had systems in place to ensure all staff completed a comprehensive induction. A newly introduced induction programme had been implemented, which included detailed shadowing shifts with structured records to strengthen staff understanding and preparedness for their roles. Staff told us the induction was thorough, supportive and helped them feel confident in their responsibilities.
The provider had also introduced a staff file audit system to ensure recruitment documentation remained robust and up to date. Appropriate pre-employment checks were completed before staff started work, including full employment histories, references and Disclosure and Barring Service (DBS) checks, to support safer recruitment decisions.
Staff completed an induction and probationary period, with ongoing training opportunities available to develop their skills, including mandatory and face-to-face training such as moving and handling.
 

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had received training in infection and prevention control, and the provider had policies in place for staff to follow, should there be any outbreaks of infectious diseases. The service had regular cleaning schedules in place and staff had personal protection equipment (PPE) available for their use. The registered manager carried out regular checks and audits to monitor the cleanliness of the service.

The service 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. The registered manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen on staff files. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. Protocols were in place for as and when required medicines (PRN). The registered manager carried out regular audits and where discrepancies were noted these were investigated to identify the cause and any actions needed. There was a system in place to identify any shortfalls and to ensure people received their medicines safely.