Background to this inspection
Updated
22 May 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of two CQC Inspector’s on the first day and one CQC Inspector on the following days of the inspection visit.
Service and service type:
The Grange – Care Home Physical Disabilities is a ‘care home’. People in care homes receive accommodation and 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 registered manager in post. A registered manager is a person who has 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:
The inspection on day one was unannounced.
What we did:
Before the inspection we reviewed information we held about the service. This included information about incidents the provider had notified us of and contacting health professionals and the local authority for their views on the service. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what it does well and improvements they plan to make.
During the inspection, we met and spoke with nine people living at The Grange to gather their views about the service and the support they received. We also spoke with four relatives for their views and spoke with ten members of staff which included the registered manager, the deputy manager, care staff and housekeeping staff.
We observed how people were supported and to establish the quality of care people received we looked at records relating to their care and support. This included individual care and support plans and a selection of people’s Medicine Administration Records (MARS). We also looked at records relating to the management of the service including; staffing rotas, staff recruitment, supervision and training records, premises maintenance records, accident and incident records, staff and resident meeting minutes and a range of the providers audits, policies and procedures.
Updated
22 May 2019
About the service:
The Grange – Care Home Physical Disabilities is a care home without nursing registered to provide accommodation and personal care for up to 27 adults who have a physical disability. At the time of our inspection there were 24 people living at the home.
At the last inspection we identified shortfalls in the deployment of staff to meet people’s needs and a need for better liaison between senior managers and people living at the home. This inspection found the provider had made improvements to these area’s however, we have made a recommendation regarding ongoing monitoring of staffing levels.
At the time of the inspection the provider was in the process of selling The Grange – Care Home Physical Disabilities. People, relatives and staff were fully aware of the impending sale but were waiting for the final details of the new provider to be shared with them.
People’s experience of using this service:
People told us they felt safe living at The Grange. They told us the staff knew them well and knew how they preferred their care and support to be given.
Staff spoke knowledgably about the systems and processes in place to safeguard people from potential abuse and knew what action to take if they suspected people were at risk of abuse.
Staff knew people well and treated people with kindness, respect and dignity whilst ensuring their independence was maintained. People received care and support in an individualised way, however, the staff team were working at full capacity in order to achieve this.
The home had undergone recent redecoration and refurbishment which had led to a new commercial kitchen being installed and the employment of a full time cook. People commented very positively about the meals that were provided and told us, “The food is very good.”
Staff were supported with a system of regular supervision, annual appraisals and a variety of relevant training courses. Staff felt the review and appraisal system offered good support and commented positively on the training they received.
The service worked closely with health care professionals to ensure people received the support they needed to manage their physical and mental health at all times.
People led active lives and were supported to access the community and trips to places of interest, a schedule of activities was available for people to participate in if they wished.
People’s medicines were being managed safely, stored securely and administered by trained staff.
People and their relatives were involved in assessing and planning the care and support they received.
People and relatives knew how to make a complaint and felt confident they would be listened to if they needed to raise any concerns.
There was a system of audits and spot checks in place to ensure the service received ongoing monitoring to review the quality of the service provided.
People and relatives expressed confidence in the management team and felt the service had a clear management structure.
More information in Detailed Findings below.
Rating at last inspection: Requires Improvement (The date the last report was published was 18 April 2018).
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved and is rated as Good overall.
Follow up: We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Good.