Middlesbrough Grange

Updated 31 August 2022

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. 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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Middlesbrough Grange is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Middlesbrough Grange is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since it was registered under the new provider. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and 10 relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, the district manager, one deputy manager, four senior care workers, three care workers, the cook, a kitchen assistant and a domestic assistant. We reviewed a range of records. This included five people’s care records, three recruitment files and multiple medication records. A variety of documents relating to the management of the service, including training information, quality assurance documents and policies and procedures were reviewed.

Updated 31 August 2022

About the service

Middlesbrough Grange is a residential care home providing accommodation and personal care for up to 45 people. The service provides support to older people and people living with a dementia illness. Support is provided in one specially adapted building across two floors. At the time of our inspection there were 39 people using the service.

People’s experience of using this service and what we found

People’s medicines were managed safely, but records around the application of creams and lotions were not robust. We have made a recommendation around this. People told us they felt safe and protected from avoidable harm. We found one safeguarding incident which had been investigated but had not been reported to the local safeguarding team or CQC. The registered manager confirmed this was an oversight. We have made a recommendation around the notification of safeguarding concerns.

Risks to people were appropriately managed and the environment was safe. People’s support plans contained good information to help guide staff to keep people safe. There were enough suitably trained staff to safely support people and staff were recruited in a safe way. The home was clean and tidy and robust infection control measures were in place. Lessons were learnt when things went wrong.

People’s needs were thoroughly assessed, and staff knew people’s likes and dislikes. Staff had the right training and support. People were supported to eat and drink enough to maintain a balanced diet and staff had good knowledge about people’s dietary needs. Staff made referrals to healthcare professionals appropriately. The home was designed to meet people’s needs with different areas for people to use.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff treated people with kindness, respect and dignity. People received person-centred care and were supported to be independent where possible and make their own choices. People were supported to communicate, and information was available in different formats for people. Complaints and concerns were dealt with appropriately.

There was a positive atmosphere in the home and staff enjoyed their jobs. There was a clear management structure and quality assurance audits were completed regularly. Communication between management and staff, people and relatives was good. Management sought feedback from people and acted upon this.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service has changed provider. The last rating for the service under the previous provider was good (published 23 May 2019).

This service was registered with us with the new provider on 6 May 2021 and this was the first inspection under the new provider.

Why we inspected

This was a planned inspection to assess the standard of care delivered by staff and award a rating.

We 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, which will help inform when we next inspect.