We carried out a review of the data available to us about The Grange Nursing and Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Grange Nursing and Residential Home, you can give feedback on this 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.
Follow up
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.
The Grange is registered to provide accommodation and nursing care for older people and some people living with dementia. Accommodation is provided in one building. The Grange is registered for 50 people, at the time of the inspection 18 people were using the service.
We found the following examples of good practice.
¿ The service was closed to non-essential visits at the time of the inspection. Government guidance had been followed for any visitors to the service and relatives were kept informed about ongoing changes.
¿ People were supported to social distance and isolate in their bedrooms where appropriate. Staff handovers were conducted in large areas of the home, however, the staff room was small which made social distancing difficult during busier times of the day.
¿ People’s needs were assessed prior to admission, including the difficulties some people may have with isolating. Care was planned to ensure people were given the support they needed, the registered manager worked with other agencies to ensure this was in the person’s best interests
¿ Risk assessments were in place for individual people and the risks of catching COVID-19. Staff who maybe at risk of the virus had also received a risk assessment and the required measures put in place to reduce the risks.
¿Testing for people using the service and staff was carried out in accordance with the guidance. This meant any positive results could be responded to swiftly. The registered manager consulted outside agencies such as Public Health England to gain advice when needed.
¿The domestic staff had completed additional cleaning, however these were not always recorded. After the inspection records for cleaning were updated.
¿ Policies in relation to infection control, admissions and staffing during COVID-19 had been completed. However, some areas needed updating to ensure they were inline with current practice. On the second inspection we found these had been amended to reflect current practice.
¿Guidance was displayed on how to use personal protective equipment [PPE]. Staff had received training in this area and had competencies to ensure they use it correctly.
¿ The first floor had been designated a Covid 19 positive section and all the required safety measure were in place. This meant that people using this part of the service would not be in contact with other people in the rest of the home.
¿ The designated scheme had its own staff group and access to all the required facilities so they could remain independent of the main home.
Further information is in the detailed findings below.