Grange Nursing Home

Updated 7 July 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 one inspector, 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.

Service and service type

Grange Nursing Home 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. Grange Nursing Home is a care home with 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 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information gathered as part of monitoring activity that took place on 02 April 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and three relatives about their experience of the care provided. We spoke with six members of staff including the registered manger. We reviewed a range of records. This included seven people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with four professionals who regularly visit the service.

Updated 7 July 2022

Grange Nursing Home is a residential care home providing personal and nursing care to up to people. The service provides support to 32 people. At the time of our inspection there were 24 people using the service.

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

Risk was assessed, and plans put in place to guide staff on how to safely manage areas of risk. However, records used to monitor risk were not always completed to show people had received the safe care they needed.

The systems for monitoring the quality and safety of the service were not always used effectively. They failed to identify and mitigate risk and bring about improvements.

It was observed during the inspection that people were comfortable and happy in the presence of staff who interacted with then in a caring and patient manner.

Systems and processes were in place to safeguard people from the risk of abuse and family members told us they felt their relatives were safe with staff. GPs and other healthcare professionals were contacted for advice about people’s health needs whenever it was identified as necessary.

Medicines where managed safely. Infection control standards were also monitored and managed appropriately. Accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence.

Staff were recruited safely and there appeared enough staff available to meet people's day to day needs. Feedback from people and their relatives indicated that there were familiar staff on duty including the use of agency staff.

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.

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

Rating at last inspection and update The last rating for this service was requires improvement (07 August 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. At this inspection we found the provider was in breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We also received concerns in relation to people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements in regard to governance and reporting. However, the provider has taken prompt action to mitigate the risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Grange Nursing Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.