The Grange

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service registered under a new provider in September 2024. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The registered manager had instigated several changes and a range of improvements. Monitoring systems were in place, although the registered manager acknowledged there was still more work to do. Governance systems were in place and overseen by the registered manager. Senior managers in the organisation oversaw the running of the service, although their formal audit processes need to be improved. People, staff and professionals were all highly positive about the registered manager and the improvement they had brought about at the service.

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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider and the registered manager had a clear vision of the culture and outcomes required for the home. Professionals were highly positive about the improvements the registered manager had brought about within the service and their impact on the home. A professional told us, “A lot of improved processes have been put in place. [Registered manager]has been making sure policies and procedures are more robust and embedded. They have a stable set of staff who have good relationships with residents. A lot of positive environmental updating has been going on and better furnishings.”

Staff shared this vision and understanding of the need to provide high quality, personal and safe care.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

People, relatives, and professionals were positive about the work and influence the registered manager had on the service. They noted improvements had been made to the home and the processes put in place to ensure care was safe.

Staff said that managers at the service were actively involved in the running of the home and supportive to staff. Comments from staff included, “Senior managers are very supportive. [Director] and [Provider] will support you with anything. They come and speak with the residents and chat with the staff. [Regional manager] is really good. She has been in the service for a long time” and “[Registered manager] is very approachable and has an open-door policy. You can go in and have a chat with them anytime. If you need to raise a personal issue you can. [Regional manager] is also about and approachable, if you need to speak.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People said they could easily raise any issues or concerns, and we saw evidence that issues brought to the registered manager’s attention had been considered.

Information regarding the company’s whistle blowing policy was available to staff. Staff told us they were aware of the process and knew how to raise any concerns.

Staff had received a range of training including safeguarding adults training and how to raise whistle blowing concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The culture of the service strongly valued diversity and people from a range of cultures worked within the service. The home had several staff from abroad who were working under the government sponsorship system. They told us they were fairly treated and well accepted within the home.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The registered manager had put in place a range of audits and checks to ensure there was appropriate oversight of people’s care. Some of the audits were of better quality than others, and it was not always possible to see if actions had been taken in relations to certain issues. However, overall, there were sufficient checks in place to ensure appropriate action was taken.

Directors of the service and the provider also visited the home and carried out checks, including speaking with people and relatives. These audits were less robust, and it was not clear that any issues noted had been followed up or fully addressed. We spoke with the registered manager about how these senior manager checks could be improved.

Professionals were positive about the work the manager was doing at the home. One professional told us, “Generally, it’s very pleasant, staff get on well, residents appear happy, relatives are happy with care standards – one of the nicer ‘homely’ homes.”

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager spoke about how they had worked to engage with the local community and with local organisations to promote inclusivity for people who used the service. They told us about ongoing efforts to encourage partnerships across the locality and engage with key individuals to endorse equality.

Professionals were positive about the efforts made by the registered manager to work closely with partner organisations and improve communication about the service and with people living at the home.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Staff told us there was access to a range of training and development and the service’s training matrix showed most staff were largely up to date with required training. There was evidence that significant events and safeguarding matters had been considered on an individual level and that the registered manager had looked at accidents and incidents in relation to wider causes. Action had been taken in relation to this learning, which in some cases had led to reduced falls for identified individuals.

The registered manager acknowledged there were still improvements to be made at the service and was actively working to improve care and supportive processes. Where we raised issues during the assessment the provider and the registered manager took these on board and made changes or improvements to processes.