6 August 2021
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.
The inspection was carried out by two inspectors.
Service and service type
The Grange Nursing and Residential 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 did not have a manager registered with the Care Quality Commission. As the provider, they are legally responsible for how the service is run and for the quality and safety of the care provided. However, a manager had recently commenced their employment at the service, who advised they were preparing to submit their registration application to us.
Notice of this inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
What we did before the inspection
We reviewed information we received about the service since initial registration. This included any written notifications the provider sent us, about important events when they happened at the service and the provider’s information return. This is information providers are required to send us to tell us about their service, what they do well and any improvements they plan to make. This helps us to plan and to supports our inspections. We also contacted local authority care commissioners and two external health professionals involved in people’s care at the service.
During the inspection
At our visit on 22 June 2021 we spoke with five people about their experience of the care provided. We spoke with an acting manager, the newly appointed home manager, the deputy/senior personal care lead, an agency nurse, two care staff, a cook, a kitchen assistant and the nominated individual for the provider. We looked at six people’s care plan records, multiple medicines records; staff recruitment records, complaints records and records of the servicing and maintenance of equipment used for people’s care at the service
After the inspection
On 28 July 2021 we spoke with three relatives and three staff by telephone. We also reviewed a range of documents which we asked to provider to send us, relating to the management of the service. This included management and care policies, quality assurance audits and staff training information.
6 August 2021
About the service
The Grange Nursing and Residential Home provides accommodation in one adapted building; personal and nursing care for up to 50 older people including some who may be living with dementia. At this inspection there were 19 people accommodated. This included nine people receiving nursing care and 10 people receiving personal care.
People’s experience of using this service and what we found
People were protected from the risk of harm or abuse within the service. The provider’s staffing, risk management and safeguarding arrangements for people’s care, helped to ensure this. Management remedial actions to fully ensure medicines safety were identified and agreed but these improvements were not yet fully demonstrated as embedded and ensured ongoing.
Infection, prevention and control was managed well, and guidance followed in line with COVID-19. Health incidents and near misses were routinely monitored and analysed, to help inform or improve peoples’ care and prevent any further reoccurrence when needed.
There were effective arrangements for the assessment and delivery of peoples’ care in line with nationally recognised standards and the law. People were supported to maintain or improve their health and nutrition through timely consultation with relevant external health professionals when needed for people’s care.
Staff were trained and supervised for their role. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible. The provider’s related policies and systems supported this practice.
Standardised and lawful information sharing, helped to ensure people received timely, consistent care as agreed with them, including when they needed to move between services
People received care from kind, caring staff who knew people well and how to communicate with them. Nationally recognised care values were promoted to ensure people’s equality, rights, independence and choice in relation to their care and daily living arrangements.
People received timely, individualised care, which they were happy with. People who were living with a life limiting illness were effectively consulted and supported to agree and receive care against nationally recognised standards concerned with end of life care.
The provider was meeting the accessible information standard, to enable people to understand and agree their care in accordance with their assessed needs. Complaints were effectively handled and used to help to inform any care or related service improvements when needed.
The service was well managed and led. Regulatory requirements were being met and staff understood their role, responsibilities and legal requirements for people’s care.
The provider operated effective governance and service oversight arrangements to ensure the quality and safety of people’s care. Effective communication, record keeping and information handling was also ensured, along with partnership working for people’s care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
This service was registered with us on 10/04/2020 and this is the first inspection. The last rating for the service under the previous provider was Requires Improvement, published June 2019.
Why we inspected
This was a planned initial ratings inspection of the service for this registered provider.
We also 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.
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.