Grange House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last inspection the manager had left the service. The provider had not employed an interim manager or appointed a named person in charge. The provider did not always understand the challenges and needs of people living in the home. Oversight had not been sufficient to identify challenges or facilitate ongoing improvement.

Without consistent leadership and management at the home on a daily basis the values and culture of the home had not been adequately supported.

The provider and staff were open to feedback and acknowledged where things needed to be improved. A new manager had recently been employed and started at the home a week after the inspection.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively. The provider was available daily by telephone but were not located locally. Despite being available to speak on the telephone, they only visited the home approximately once a month. The last visit to the home had been in December 2025.

In the absence of a manager at the home, senior care staff had been required to carry out some of the management tasks without adequate supervision and support. Care staff did not have the skills or experience to ensure all management tasks were completed effectively. This also took them away from their care commitments which led to staff rushing to complete all the tasks needed. It was clear that staff had worked tirelessly to ensure people’s care and support needs had been met despite the challenges.

People were not always given the opportunity to speak up or feel that their voice would be heard.

There was no registered manager in place and a lack of day-to-day provider oversight within the service. Senior staff were working hard to maintain care standards.

There had not been any planned staff meetings in recent months. Two group supervisions had been completed by the provider, one in September 2025 and the other during the inspection on 9 January 2026. The first attended by 5 staff the second by only 4 staff.

The absence of planned meetings or one to supervision opportunities for staff to speak up and be heard were minimal. There was a whistleblowing policy, and staff told us they were aware this was in place.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they felt they were treated equally and with respect. A number of overseas staff were sponsored to work at the home. Policies and procedures were in place to support all staff and staff had access to training.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Grange House had not had a registered manager since 2023. An acting manager had been working at the home until October 2025 but they had not completed their registration with CQC. At the time of the inspection there was no manager on site to provide day to day support and the home did not have a deputy manager. A new manager had recently been employed and was due to start the week following the inspection. In the absence of a manager, senior care staff had been expected to manage the service.

The provider had set up a staff messaging group for staff, and was available by telephone, they called the service daily and participated in handover meetings over the telephone. Staff told us the provider visited the home at least once a month, however, they were not locally based so were unable to be onsite. No management cover had been put in place to oversee the day to day running of the home and to ensure the maintenance of required monthly checks and governance processes.

Senior care staff had been expected to pick up a number of management tasks, others had not been completed since October 2025. We found gaps in documentation and a lack of robust governance systems in place.

Delegated tasks had not been overseen by the provider to check they had been robust, for example, water flushing and temperature checks, medicines audits and care reviews. No medicines competencies had been completed, this is to observe staff practice and ensure best practice at all times and no spot checks or other observations documented. There had been no analysis of accidents and incidents to identify any areas of learning or improvement.

Monthly governance checks for the service and systems had not been completed since October 2025. This included a number of environmental checks. Inspectors were unable to locate legionella and gas safety certificates. We found serious fire safety concerns which had not been addressed in a timely manner despite being highlighted in the fire risk assessment in June 2025. We asked the provider to take immediate action to resolve the most serious fire safety concerns, and this was completed before the end of the inspection. We have had confirmation from the provider that other concerns raised at inspection have now been fixed.

Staff recruitment needed to be improved and did not include all appropriate information. Newly employed staff had not completed a structured or documented induction. There had been 2 group supervision in recent months attended by a small number of staff, but no staff, resident or relative meetings and no one to one supervision.

Care plans were being updated by care staff and reviewed by senior care staff. However, we found a number of discrepancies and information did not always correlate across sections. Senior staff were working hard and taking on tasks previously completed by the manager without appropriate training and experience.

The provider did not have an ongoing improvement plan to highlight all areas which needed to be addressed. They lacked oversight of the level of the concerns. When raised by inspectors the providers have acknowledged the issues and responded promptly to make improvements to ensure overall safety at the home.

Following the inspection the provider has confirmed a new manager is in post and has started working at the home.

The provider understood their duty to collaborate and work in partnership, so services worked well together. They share information and learning with partners and collaborate for improvement. Staff made sure that people received care and support which met their needs.

Staff were heard liaising with healthcare professionals to organise support visits. Staff were confident to organise support, for example, staff told us for a recent admission to the home they had contacted the GP surgery to arrange a community nurse to attend and administer specific medicines. The moving and handling trainer had been requested by the provider to provide on site training for staff. This would ensure staff were competent to use any new equipment provided by the OT to mobilise a person safely. In the interim staff had agreed with the OT a short-term way of working to maintain safe care.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The provider had not carried out robust auditing or analysis to identify any trends or themes, or areas of learning to take forward to continually improve the service. There was no service improvement or action plan in place to identify areas for improvement and monitor how these were being addressed. However, the provider responded to concerns raised during the inspection and identified ways to improve.