The Grange Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This was the first inspection for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. The registered manager used the information to identify areas where lessons could be learnt. A staff member said, “When issues have arisen we have looked closely at why and put in place plans to reduce them happening again.”

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. A relative said, “[Person’s name] had been extremely challenging at home and when first going to the home, but staff persevered with them and they are now relaxed and happy, which is wonderful.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Staff had training and a good understanding of what to do to make sure people were protected from harm or abuse. The management team ensured DoLS authorisations were sought when needed and any conditions imposed by them were followed.

The service worked with people to understand and manage risks but at times were not thinking about these holistically. When completing risk assessments staff needed to consider wider risk and design ones for specific issues an individual might face, for example, risks associated with using specific equipment. Risks were reviewed when people’s needs changed but staff needed to make sure the related assessment record was updated. When we raised this matter the registered manager and deputy manager immediately started to improve the risk assessments. A person said, “Staff have been brilliant, and make sure I’m safe when we go out and about.”

The service detected and controlled potential risks in the care environment. Environmental risks were assessed and addressed. They made sure equipment, facilities and technology supported the delivery of safe care and worked with external professionals to review people’s aides. People were supported to be as independent as possible within the environment. The staff team knew who to contact when people might benefit from additional aids or equipment, which staff knew how to use.

The service took steps to ensure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. During the weekday there were enough staff to deliver the care. Overnight there was just enough if nothing untoward occurred. To ease pressures on the nightshift the registered manager has introduced a system whereby a dayshift staff member completed a 7am – 7pm shift and they had worked with local GPs to move the majority of people’s medicines to evening rather than nighttime. However, this meant a loss of flexibility for people around when they wanted to receive medication and staffing changes pressure on at different times. The regional manager had noted these issues and was already looking to employ twilight cover. Recruitment practices were meeting requirements. However, staff needed to ensure the information was stored in the relevant folders. The administrator was in the process of obtaining current photographs for all staff members.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff appropriately followed the required infection control guidelines.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff who administered medicines had the appropriate training and competency checks. The staff worked closely with the GP and pharmacist to manage the medicines and determine appropriate administration times for them. A relative said, “The staff make sure their medicines are right and the GPs are really good. We have no concerns.”