The Grange

Updated 23 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, a senior support worker, four support workers and a cook.

We reviewed a range of records. This included four people's care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We requested additional documents to be sent to us electronically, including audits and quality assurance documents. We spoke with one professional who regularly visits the service.

Updated 23 June 2021

About the service

The Grange is a residential care home providing accommodation and personal care to people living with a mental health condition. The service can accommodate up to 18 people in an adapted building over two floors. At the time of inspection, 17 people were living at the home.

People’s experience of using this service and what we found

Infection prevention and control measures had greatly improved since our previous inspection. Staff wore appropriate PPE and disposed of used PPE safely. Visitors were screened for COVID-19, and improvements had been made to the safety and cleanliness of the environment.

People told us they felt safe and well cared for. People’s care plans contained detailed and person-centred information to enable staff to support them safely. Care plans and risk assessments had been implemented for emergency and urgent admissions.

Staff had received further training to address shortfalls in staff knowledge identified at our previous inspection. There were enough staff on duty and staff were recruited safely. Accidents and incidents were recorded. Lessons learnt were shared and communicated promptly to staff. Medicines were safely managed.

The management team was approachable and supportive. Audits were undertaken regularly, and the audits effectively identified areas for improvement. Action plans were created and put into place. Feedback was sought and encouraged from people, staff and relatives. The service worked well with other professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 February 2021) and there were multiple breaches of regulation. We issued conditions on the provider’s registration regarding infection prevention and control. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, and good governance.

At this inspection we found improvements had been made, the provider was no longer in breach of regulations, and the provider had met the conditions issued against their registration.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to check whether the conditions we previously served in relation to regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection (published 18 February 2020) for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection and our last focused inspection, by selecting the ‘all reports’ link for The Grange on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.