Archived: The Grange Nursing and Residential Home

Updated 23 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we reviewed the information we held about the service, including the previous inspection and notifications the provider had sent us. A notification is about important events, which the provider is required to send to us by law.

We contacted the local authority contracts and commissioning team that had placements at the home.

The inspection took place on 27 April 2015 and was unannounced. The inspection team comprised of three inspectors, a specialist advisor 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. The specialist advisor was a nurse with experience of nursing older adults.

On the day of our inspection we spoke with 12 people at the service, seven staff, the registered manager, the regional manager, 11 visiting relatives and health professionals.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people using the service, who could not express their views to us.

During the inspection we looked at records and documentation relating to the running of the home. We reviewed four care plans, and records in relation to the management of the home such as audits and checks.

Updated 23 September 2015

This inspection at The Grange Nursing and Residential Home took place on 27 April 2015 and was unannounced. We last inspected the service in June and July 2014 and found it was not meeting some of the regulations at that time. These were in relation to ensuring people were protected against the risks of receiving care or treatment that was appropriate or unsafe, risks associated with the unsafe management of medicines and not notifying us of incidents. Following our last inspection the provider sent us an action plan to tell us the improvements they were going to make. At this inspection we found the actions we required had been completed and these regulations were now met.

The service had a registered manager who was available throughout the day of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Grange is a nursing and residential care home for up to 50 older people, some of whom have dementia. At the time of our inspection there were 28 people using the service. Accommodation is on two floors and there is a lift for access between floors. The building is going through a process of decoration and refurbishment which has started on the ground floor.

People who lived at the service told us they felt safe, secure and well cared for. The service had systems and checks in place that were used with the intention of keeping people safe. Accidents and incidents were dealt with in a timely manner and any actions and lessons learned were recorded and reviewed by the provider.

Staff knew what actions to take should they suspect abuse and received appropriate training in keeping people safe. Arrangements were in place to keep people safe in the event of an emergency.

The provider had arrangements for the safe ordering, administration, storage and disposal of medicines. People were supported to take their medicines at a time when it was needed.

People were supported to maintain good health and had access to health care services when it was needed. People were supported to eat a nutritionally balanced diet and were given choices of meals.

The registered manager and the staff team followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff training records showed staff had attended training in MCA and DoLS.

People received care and assistance from staff who knew their needs well. Each person at the service had their own care plan and their needs, choices and preferences had been clearly documented and were known to staff. People were supported to maintain contact with their family and friends and visitors were welcomed to the home.

Some people told us there were not enough staff working at the home. We found there were sufficient staff to meet people’s needs and call bells and requests for assistance were responded to in a prompt and timely manner. The registered manager had recognised more staff were required at certain key times and was in the process of recruiting.

The provider sought feedback on the care it provided and monitored the service to ensure that care and treatment was provided in a safe and effective way and when necessary changes were implemented.

Any complaints that were received were documented along with the actions taken. There was an effective system in place to monitor the quality of service provided. The registered manager and the staff team had made a number of noticeable improvements since the last inspection.