Grange House

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

People received safe care from staff who knew them well and understood their risks and how best to support them. People received their medicines safely and in line with good practice guidelines. Some processes and documentation were in need of improvements and these were underway by the end of our assessment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

Not everyone could share their views, one person told us, “I’m do feel safe, I had a rotten tooth and I saw a dentist, they do support me and I like it here.” Another person told us,“Yes I'm safe, I get the food I like “ Relatives told us, “I trust them totally -very kind and very safe. They have got a therapist in to help with moving as after the hospital stay, their mobility had gone, but hopefully they will get a bit better," and “I trust them 100%-she is safe here, they support me as well to take her out “

Staff told us, “The manager visits each resident and staff on their walk about everyday,” and “Things have improved -the new manager is very knowledgeable and good, we have regular meetings and he’s here in the home and will always help or advise, We do checks on beds, medicines and cleanliness.” The manager said, “I have only been in post for two months, there has been many things that needed to improve and we are doing really well, care plans and risk assessments need some changing regarding wording and to be clearer, but we will get there.”

We spent time with people and staff both in communal areas and in their bedrooms. People who were currently on bed rest had air flow mattresses and these were set correctly as per manufacturers guidance against peoples weight. Staff recorded these checks on the persons care documentation. We saw sensor mats were in place for some people and these were placed safely with wires hidden. Call bells were in peoples rooms, and there were risk assessments in place for those who can't use a call bell and these people were checked regularly by staff. We saw this happen in practice. We checked fire equipment was checked and they were in date, Fire exits were clear from obstruction. Outside areas were clear and accessible to all people. Doors were coded and all stairs had stair evacuation slides checked and in date All floors were safe -the dining room floor was sticky underfoot but this was due to a paint reaction to flooring and is due to be replaced . All corridors were wide enough for wheelchairs if required and seating in communal areas were in good condition and of variable heights and style, so people had a choice.

Care plans and risk assessments identified specific risks to each person and provided guidance for staff on how to minimise or prevent the risk of harm. These included risks associated with diabetes, mobility, skin integrity and eating and drinking. We discussed that some risk assessments and care plans were not reflective of recent changes to peoples health. This was acknowledged and work was currently being undertaken by the newly appointed manager to review all care documentation. The impact on outcomes was minimised due to stable staff teams and the manager attending all staff shift handovers and meeting every person and staff member on a daily basis. This was confirmed by all staff spoken with. Staff told us how they used risk assessments in a proactive way to enable people to remain active and independent. Staff understood how to manage and mitigate risks and used the Mental Capacity Act to underpin decision making. Staff gave us examples of where reviews of risks had been carried out and appropriate measures taken and recorded to further reduce risks. For example, there were people who were at risk falls from bed had crash mats, sensor mats and in some cases bedrails. There were detailed fire risk assessments, which covered all areas in the home. People had Personal Emergency Evacuation Plans (PEEPs) to ensure they were supported in the event of a fire. These were specific to people and their needs. Premises risk assessments and health and safety assessments had been reviewed on an annual basis, which included gas, electrical safety, legionella and fire equipment. The risk assessments also included contingency plans in the event of a major incident such as fire, power loss or flood. The lift was out of order and risk assessments had been undertaken for both staff and people and a contingency plan was in place to ensure minimal impact on people. For example, extra staff on each shift.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People's medicines were managed safely. Feedback from people included, “Yes I do get my medicine when I need to.” Relatives told us, “They inform me of any changes, and they review with us the family -I think the GP has also contacted me," and "Staff know what they are doing, they keep me informed especially since they came back from hospital."

Feedback from staff included, "We all have had medicine competencies by the manager, (seen and confirmed). We use the eMAR, we had training on it and we had competencies," Staff also told us, "The pharmacist also supports us, if we have questions we can go to them, they are helpful," and "We use google or the BNF (British National Formulary) to check medicines if we need to -but we also use eMAR to check on contraindications on new medicines -if we have a question we can ask the nurse or GP."

People received their medicines in a way that met their individual needs and preferences. Staff showed kindness and respect to people within the service whilst supporting with their medicines . The service had safe systems for appropriate and safe handling of medicines. The service used an electronic medicine administration record (EMaR, such as The clinical room was clean and tidy. Policies and procedures were in place and had been reviewed in January 2024. Staff who gave medicines had the relevant knowledge, training and competency that ensured medicines were handled safely. We observed staff giving medicines safely and these were recorded accurately on the EMaR. Risk assessments were in place for certain medicines, such as blood thinners and seizure controlling medication. Any discrepancies and medicine errors were recorded and investigated and action taken as required. Daily and monthly audits were carried out, and any shortfalls were addressed. As required medication (PRN) protocols (documents to support staff to know how and when to administer PRN medicine), contained enough information to support staff in administering medicines consistently, as intended. At present, due to the lift being out of order an interim medicine administration policy was being followed that directed staff to administer medicines to people individually from the clinical room. This had been considered within the extra staffing provision at this time. This had ensured medicines were handled safely. We observed this safe practice.