Grange Court Residential Home

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 assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.
 

This service scored 81 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.
The service demonstrated effective learning from incidents, audits and feedback. Reviews of accidents, incidents and hospital admissions were undertaken and used to identify areas for improvement, including the need for the timely escalation of concerns and the appropriate use of ‘as required’ (PRN) medicines. Actions had been implemented to reinforce staff practice and mitigate identified risks.
Lessons learned were used to drive improvements across the service. These included improvements to the storage of topical creams, strengthened data protection practices and enhanced oversight of audit action plans to ensure actions were completed and formally signed off.
Learning was also embedded within people’s day-to-day care. Adjustments had been made to personal care routines to reduce anxiety, and feedback relating to medicines management and mealtime experiences had been addressed through staff retraining. This demonstrated learning was effectively identified, shared and embedded into practice to improve safety and outcomes.
 

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.
The service operated a highly robust and consistently applied pre-assessment process which ensured people received safe, person-centred care from the earliest stage of their journey. Assessments were typically completed face to face, enabling staff to build a detailed understanding of people’s needs, preferences, risks and personal circumstances, alongside meaningful involvement of relatives and those important to them.
This approach demonstrated a strong commitment to person-centred care and thorough risk planning. Information gathered during pre-assessments was used effectively to inform initial care plans, ensuring continuity, consistency and safe delivery of care from the point of admission. The process was not only comprehensive but also responsive, allowing the service to anticipate needs and put appropriate measures in place prior to admission.
The service placed a clear emphasis on collaborative and inclusive decision-making. Assessments considered not only whether the service could meet the person’s needs, but also their compatibility within the service environment. This ensured admissions were both safe and sustainable, reducing the risk of placement breakdown and promoting positive outcomes for both new and existing people using the service.
Admissions were described as seamless, reflecting effective communication, strong planning processes and well-coordinated transitions. This demonstrated a proactive and well-embedded system which prioritised safety, dignity and stability for people moving into the service.
Continuity of care was maintained when people moved between services, with staff having access to records and sharing these safely with other professionals to ensure they had all necessary information to provide safe care and treatment.
 

The provider 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 provider shared concerns quickly and appropriately.
Safeguarding systems within the service were well organised and effectively maintained. A safeguarding log was in place which clearly recorded concerns and notifications, including links to relevant CQC references, supporting oversight and accountability.
Records relating to statutory notifications were up to date and easy to follow, and the provider had systems in place for the management of Deprivation of Liberty Safeguards (DoLS); these were clear and current. The service maintained a detailed matrix which identified people with authorised restrictions and any associated conditions, enabling staff to monitor and ensure these were met.
People and relatives told us they felt safe in the service.
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.
Risk assessments were in place for people using the service and provided staff with clear guidance on identified risks, alongside appropriate measures to reduce these. These included practical instructions to support safe care delivery while promoting people’s independence.
Following accidents or falls appropriate action had been taken to manage the risk, and we saw evidence there had been no further incidents for some people This indicated risks were recognised and responded to in a timely way.
People were supported to remain involved in managing their own safety. For example, some people used wearable lanyards fitted with alert buttons, enabling them to call for assistance if they fell. This approach supported people to maintain independence while ensuring support could be accessed promptly when needed.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The environment was safe, well maintained and presented to a high standard. Bedrooms and communal areas were clean, attractively decorated and comfortably furnished. People were supported to personalise their bedrooms and were able to bring in personal belongings and furniture, which helped promote a sense of familiarity and independence. There were a range of attractive communal spaces, and people were able to access a safe outdoor garden.
People and relatives told us the service was safe and well maintained. One person said, “I would recommend this place, just look at the lovely garden.”
Systems were in place to ensure the premises and equipment were safe. Records confirmed required safety checks, servicing and certification for equipment and the environment had been completed and were up to date.
Fire safety arrangements were in place. People had Personal Emergency Evacuation Plans (PEEPs), which were readily accessible in a grab file to support staff in the event of an emergency. However, the service was not able to consistently evidence fire evacuation drills had been regularly completed, as records had not always been maintained. This was identified as an isolated recording issue and did not have a wider impact on the overall safety of the service.
 

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.
Staffing arrangements within the service were effective and consistent. Recruitment processes were safe and included all required pre-employment checks, helping to ensure only suitable staff were employed.
Staffing rotas demonstrated appropriate staffing levels across all shifts, which supported the safe and consistent delivery of care.
The registered manager monitored and maintained a training matrix which showed good levels of compliance across a wide range of training courses, ensuring staff had the skills and knowledge required for their roles. Systems were also in place to monitor staff supervision and appraisal.
People and their relatives reported the service was sufficiently staffed. One person told us, “They all know what they are doing, staff are always so cheerful and smiley.”
 

The provider thoroughly assessed and managed the risk of infection. They always quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly.
The provider demonstrated strong and effective infection prevention and control systems, which were well embedded into daily practice. Infection prevention and control (IPC) and housekeeping audits were regularly completed and were detailed, supporting ongoing monitoring and high standards of cleanliness.
The environment was observed to be consistently clean, fresh and free from malodours, reflecting the effectiveness of these systems in practice. Domestic staff followed robust and structured cleaning schedules, which included all communal areas, bedrooms and high-touch surfaces. Handwashing facilities and bathrooms were well stocked, promoting good hygiene practices across the service.
The service had implemented additional measures to further enhance infection control. This included the use of an ozone machine within bedrooms following infectious episodes. This proactive approach supported effective decontamination of environments and reduced the risk of cross infection, demonstrating practice beyond standard cleaning methods.
Staff were observed to follow IPC guidance consistently, including appropriate use of personal protective equipment (PPE) and maintaining bare below the elbows as good practice. This demonstrated a strong and embedded culture of infection prevention and control across the service.
People and relatives confirmed the service was clean and well maintained. One person told us, “This place is very clean, we don’t have anything to worry about here, they look after us very well.”
 

The provider 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.
Processes were in place to support the safe management of medicines. Medicines were stored appropriately, and temperature monitoring was undertaken to ensure safe storage conditions. Medication competencies were up to date, and staff responsible for supporting people with medicines had received appropriate training and assessment to carry out this role safely.
Controlled drugs were managed effectively. Records were accurate, up to date and subject to routine checks, supporting safe governance and accountability. Medicated creams were administered appropriately, with oversight from senior staff, and people were supported to receive their medicines as prescribed and in a timely manner.
Protocols were in place for medicines prescribed on an ‘as required’ (PRN) basis. Minor discrepancies were identified within some protocols, such as inconsistencies in the description of medicine formulation, which were addressed at the time of the assessment.
Staff demonstrated a good understanding of medicines that required time-specific administration. However, the recording system in use did not always enable clear oversight of whether these medicines were consistently administered in line with prescribing guidance. Actions were underway to strengthen recording processes, including clearer documentation where medicines needed to be taken in relation to food.