Grange House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff always treated people with kindness, empathy and compassion and respected their privacy and dignity. All staff worked together to support each other. We saw housekeeping staff taking the time to stop and speak to people and heard lovely conversations when they were cleaning people’s rooms.

Care staff treated people with obvious affection and respect, ensuring peoples care needs were being met. Staff understood people’s individual experiences of dementia and memory loss, the triggers which may cause upset to people and what actions to take if needed. For example, when people became upset or confused, staff responded in a calm manner providing distraction to alleviate anxiety.

We did observe a body map and repositioning photo on a person’s bedroom wall to instruct staff. We discussed with staff that these should be removed to ensure this person’s confidentiality was maintained.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care plans included some information about people’s personal preferences, in relation to food likes and dislikes, whether they prefer male or female care staff to assist them as well as information about people’s life history and relationships. This helped staff provide personalised care and meant they were able to engage people in conversation about their lives before they lived at Grange House.

Staff were aware of people’s preferences, one person liked to sit by the reception desk where it was quieter, we saw staff checking in with them regularly and providing drinks.

The provider needed to ensure people were always offered choices and were aware of their rights to have choice and control over their own care, treatment and wellbeing.

Staff worked hard to ensure people were encouraged to maintain their independence when safe to do so and we saw examples where people were offered choices and involved in day to day decisions. However, documentation did not always include enough detail in relation to how people’s needs were met.

Personal care records were not sufficiently detailed. Staff told us people all preferred showers, however we could not see bath or shower as people’s preference in their care plans. Daily records did not always identify how personal care had been provided, for example, whether the person had been offered the choice of a bath or shower and whether this had been declined, or if it was an assisted wash in bed or a full shower. Although we saw bathrooms had baths in them, staff were not aware if these were in working order.

There was a programme of activities taking place at the home. Visiting entertainers came in each week and a member of care staff also worked some afternoons as the activity person. People told us they enjoyed the activities but would like more, we saw that a planned activity was well attended. One person told us they would enjoy more outdoor activities, including trips out and utilising the small outside garden. Another said they would like to get a daily paper as they preferred to read a newspaper to keep up with the current news rather than always watching the news on the television. One relative told us their loved one was not keen on the noise in the large lounge and visiting was difficult as the television was usually on, they felt their relative would at times prefer a quieter space, but not necessarily be in their bedroom. The home had a small lounge area, however, this was not being utilised for people who preferred a quieter environment. Staff told us this area was mostly used as a visiting area when families came to the home.

People were given a choice of meal options, we were told there were pictorial menus to assist people with choices if needed, however, we did not see these being used at lunchtime. People told us, “I have options and I can choose what I want, no faults with the food.”

People were supported to do things that interested them. One told us, “I'm able to go out and have a walk, as long as I ask and then I can stretch my legs. I have no complaints; life is what you make it." Visitors told us, “The staff are friendly and welcoming, relatives visit and staff seem to respond well when they turn up.”

Staff listened to and understood people’s needs, views and wishes and responded to people’s needs and acted to minimise any discomfort, concern or distress. However, improvements were needed to how staff were allocated throughout the day.

Staffing numbers were sufficient to meet people’s needs, with staff allocated on the rota to provide one to one support for 2 people. However, it was apparent that the lack of manager and leadership on a day-to-day basis had impacted in some areas and clear leadership was needed to ensure staff allocation was more effective.

Lunchtime was disorganised and needed to be better structured to ensure a more relaxed dining experience for people. People who required assistance with their meals did not have this provided effectively. We saw staff moving from person to person and leaving the room to carry out other tasks. Staff were calling out instructions to each other across the room and discussing who ‘needed to be moved to the lounge or taken to the bathroom’. We saw one staff member assist a person with food and a drink whilst stood over them rather than sitting with them, to aid better communication and interaction. One person had 3 staff interact with them in the space of a few minutes, information from staff was conflicting and the person appeared confused by the constant interruptions whilst taking their time to eat their meal. We saw their dessert was taken away by staff before they had a chance to eat it as this staff member assumed they had finished their meal. We spoke to staff and they were responsive to the feedback and agreed the mealtime had not been relaxed for people.

Staff recognised when people required support and responded to people’s needs promptly. Feedback from visitors was positive, one told us, “I see interactions between residents and staff on my visits and have never had any concerns, they always seem attentive and will regularly sit with and next to residents in the lounge, engaging them in conversation which is really nice to see.”

The provider supported staff but had not provided adequate support for staff to promote their wellbeing. They did not always support or enable staff to deliver person-centred care.

The home had been without a manager since October 2025. Management oversight put in place by the provider had not been sufficient whilst recruiting a new manager. Senior care staff were managing the service to the best of their abilities whilst providing care and support to people. Staff told us the provider was always available on the telephone and called daily, however, the lack of onsite management support was starting to impact on the home. We found that some staff were working long hours each week. Staff told us they were happy to do this, however, no checks or support was in place to ensure this was not impacting on staff wellbeing.

There had been minimal opportunities for staff to attend meetings or group supervision, and no one to one supervision had been completed since the last manager had left.

Staff told us they worked together and supported each other. All staff had worked extremely hard to ensure people continued to receive safe and appropriate care.