Background to this inspection
Updated
28 May 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.
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 two inspectors and a specialist advisor (nurse).
Service and service type
The Grange Nursing Home 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.
Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We asked them if they held information about this service. We used all of this information to plan our inspection
During the inspection
We spoke with three people who used the service and asked about their experience of the care provided. We spoke with 11 members of staff including, the registered manager, compliance manager, nurse, senior care worker, two care workers, laundry assistant, domestic staff, chef and kitchen assistant. We spoke with two visiting Tissues Viability Nurses who were reviewing the pressure care provided for two people.
We reviewed a range of records. This included parts of or all care records of 15 people; we also looked at multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
The registered manager and compliance manager provided additional records as required. These were sent to us within the required timeframe. We reviewed these documents such as training data and quality assurance records away from the home and used these to support our findings of the inspection.
Updated
28 May 2021
We inspected The Grange Nursing Home on 18 June 2018. The Grange Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 was registered to accommodate up to 29 older people, with age related conditions, including frailty, mobility issues and dementia. On the day of our inspection there were 24 people using the service; 11 had been assessed as requiring nursing care and treatment and 13 residential care and support.
The service was last inspected on 16 February 2016; no concerns were identified and the service was rated ‘Good’ overall.
There was a registered manager in post, who was present on the day of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People received care and support from staff that were appropriately trained and competent to meet their individual needs. Staff received one-to-one supervision meetings with their line manager.
People’s needs were assessed and care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were personalised and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.
There were policies and procedures in place to guide staff on how to keep people safe from harm and staff showed a good understanding of their responsibilities.
People were supported with patience, consideration and kindness and their privacy and dignity was respected. People were protected from potential discrimination as staff were aware of and responded effectively to their identified needs, choices and preferences. People’s individual communication needs were assessed and they were supported to communicate effectively with staff.
Thorough staff recruitment procedures were followed and appropriate pre-employment checks had been made.
Systems were in place to ensure medicines were managed safely in accordance with current regulations and guidance. People received medicines when they needed them and as prescribed.
The registered manager worked in cooperation with health and social care professionals to ensure people received appropriate healthcare and treatment in a timely manner. People could access health, social and medical care, as required.
The provider was meeting the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were provided with appropriate food and drink to meet their health needs and were happy with the food they received. People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.
The provider had systems in place to assess the quality of care provided and make improvements when needed. People knew how to make complaints, and the provider had a process to ensure action was taken where this was needed. People were encouraged and supported to express their views about their care and staff were responsive to their comments and views.