Christopher Grange Residential Care

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 service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (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, equality, inclusion, engagement and understanding the needs of people living at the home.

For example, the provider and management team worked closely together to drive improvements across the home. Significant progress had been made to the environment, staffing arrangements, governance systems and communication since the last assessment. Staff described the leadership team as approachable and supportive and told us there had been a marked improvement in culture, morale and staffing levels. Staff said they felt confident raising concerns and sharing ideas. One staff member told us, “It's so much better now, things are being improved all the time.”

External healthcare professionals recognised these improvements. One professional told us, “The current management team is responsive and maintains a positive, open working relationship with external healthcare professionals.” Relatives were equally positive about the changes made. One relative told us, “There is a much more structured and managed approach to care, in particular since the senior management team changes following [manager's] appointment.”

The provider had leaders with the skills, knowledge and experience to lead the home effectively. For example, managers were visible, approachable and committed to creating a positive culture for people and staff. They maintained oversight through audits, governance processes, risk reviews and regular engagement with people, relatives and staff. Staff told us managers were supportive, listened to their views and were approachable when advice or support was needed. People and relatives valued the regular presence of managers within the home and felt reassured by their involvement in day-to-day life. Leaders promoted staff development through supervision, appraisals and team meetings and actively sought feedback to help improve people's experiences and drive continued improvement across the home.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. For example, the provider and managers had introduced systems to encourage feedback, raise concerns and improve communication across the home. Records reviewed showed concerns raised by people, relatives and staff were listened to, investigated and acted upon, with outcomes monitored through governance processes and improvement plans. Staff told us they felt confident raising concerns and sharing ideas, describing the leadership team as approachable and supportive. One relative told us managers were, “Always visible and approachable” and said their experience of raising observations and discussing changes in their relative's needs had been, “One of complete collaboration to [relatives] care and ongoing adjustment of need.”

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. For example, staff were recruited from a diverse range of backgrounds and were supported through regular supervision, appraisals, team meetings and development opportunities. Training records demonstrated staff had completed Equality, Diversity and Human Rights training and had access to the provider's Equality, Diversity and Inclusion policy. Staff spoke positively about the personal support they had received, particularly during challenging circumstances, and said leaders were understanding and approachable. One staff member told us, “The support is amazing."

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. For example, medicines audits had not been effective in identifying all of the concerns found.

However, following our assessment medicine incidents we identified were investigated and actions taken to reduce the risk of recurrence. Since the introduction of a new management structure, governance systems had been strengthened. Managers used audits, daily flash meetings, management walkarounds and quality checks to oversee the home, identify risks and drive improvements. Records showed these systems were used to monitor care, staffing, accidents and incidents, safeguarding concerns, healthcare appointments, medicines, maintenance issues and people needing additional support. Risks relating to falls, pressure damage, weight loss, nutrition and hydration were regularly reviewed, with actions put in place and monitored to reduce the likelihood of harm. Environmental audits, cleaning schedules and monitoring records demonstrated oversight of cleanliness, safety and the environment, helping to maintain standards and support continuous improvement across the home.

The provider worked in partnership with other organisations to help ensure people received coordinated care and support. For example, the home worked closely with GPs, community health professionals, hospital teams, social workers, mental health services and people's relatives to support people's health, wellbeing and changing needs. Information was shared appropriately to help maintain continuity of care and respond to changes in need. One healthcare professional told us, “The current management team is responsive and maintains a positive, open working relationship with external healthcare professionals.” Professionals reported managers were receptive to concerns, acted on feedback and had made improvements in communication, responsiveness and collaborative working, helping to achieve positive outcomes for people.

The provider focused on learning from experience and making improvements across the home. For example, managers used information from audits, incidents and governance meetings to identify risks and improve the quality of care. Records showed incidents were regularly reviewed and discussed to help prevent similar events from happening again. Falls analysis reports were used to look at patterns and identify common causes, such as unwitnessed falls, mobility difficulties and environmental hazards. As a result, actions were taken, including increasing monitoring, checking the environment, reviewing mobility support and updating risk assessments and care plans.