Grange House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The culture of the service was positive and one where staff felt valued and well supported in their roles, and able to ask anything or make suggestions for improvement of the service. The manager was available and approachable to staff, people and families. There were systems in place to monitor the quality of care, but the action taken was not always documented and evaluated. Staff however, knew of changes to people health and well-being through meetings and communication on shift.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff informed us that they had been without a manager which had led them to feel unsupported but with the new manager in post this had changed as he was very supportive and involved in getting to the residents and them as a staff team. Staff spoke to us about the vision of the service. One staff said, “It’s been a strange few years with different managers and staff, but we are feeling confident with our new manager, he’s very approachable and calm, very knowledgeable, we are moving forward and it’s a good feeling, being supported.” Other staff also said, “The manager was approachable and keen to listen, and that they feel well supported.”

Staff commented they understood their roles and responsibilities and that people were at the centre of their role. Feedback from staff was consistently positive and enthusiastic. The service aimed to give people consistently good care and staff worked together to try and achieve this. Individual and group staff supervision, and team meetings were used by the management team to remind staff about their organisations underlying core values and principles. The manager and staff understood and supported people’s cultural and spiritual needs. People were treated equally and their individual needs were met in line with their preferences. The management team knew people well and also worked alongside staff to support and promote good practice. All the staff were positive about the staff team and the future of the home.

Staff told us, “The manager is very visible, he visits each resident every morning and speaks to each member of staff, will also help out if needed.” Another staff member told us, “The manager takes time to share with us any changes and will listen to any worries.” A new member of staff told us, “I felt very supported on my induction, the manager and staff were very welcoming, lovely place to work.”

The manager had only been in post for 2 months and was committed to improvement and was open and transparent regarding the improvements made and those that were on going. He had submitted his application to register with the CQC. The manager has extensive experience both in the NHS and in adult social care and is passionate about delivering good quality care. We were told that the focus of the service was to ensure people were safe and happy, and that any learning was taken forward positively. The manager led by example and this was respected by staff. Staff told us he was very knowledgeable and supported them to speak up. There were systems and processes in place to support staff development and progression within their roles. Senior care staff were supported to become medicine givers and received support and training. Regular supervisions, spot checks, competencies and values-based supervisions took place. Recruitment practices were robust and ensured that only suitable staff were employed to work within the home. The manager was very clear about recruitment processes and the importance of prospective staff interviews and employment history to ensure that additions to the staff team were a good fit with existing staff members.

Staff told us that felt able to raise concerns. One staff said, “We receive safeguarding training on how to raise concerns, if I felt it wasn’t taken forward I would do it or raise it anonymously, but the manager would raise it.”

The provider and manager understood their responsibilities under the duty of candour. The Duty of Candour is to be open and honest when untoward events occur. We have not always received notifications as required. We had not been informed that the lift was currently out of action and the impact it had on the running of service: following discussion this was immediately submitted on the first day of assessment. Appropriate actions however had been taken, for example, extra staff deployed, a contingency plan put in place and families informed. During our assessment we found that the management team were open and transparent. They admitted when things had gone wrong and demonstrated how they had used these to make improvements. Staff were supported and enabled to voice their views and concerns. They were aware of the whistle blowing policy but felt that they could raise them and be listened to. The provider had up-to-date whistleblowing policies and procedures which were in line with current guidance. Relatives confirmed they knew how to complain, and a copy of the complaints policy was available in the home. A record of complaints was held in the service. These included the information on the complaint and how this was responded to. We saw complaints had been responded to and actions taken as necessary. We discussed that the website was not accurately reflecting the current rating and this has been addressed.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us, “There are different audits we get involved in, like infection control, and medicines, some are weekly, daily and monthly.” Staff told us, “It keeps the service safe, because it picks up things we need to do better.”

Quality assurance systems were in place and were being used to improve the service. There were areas within the audits that needed to be improved to ensure outcomes and actions were clearly documented. The management team were working to ensure there was consistent oversight and effective governance at the service. The manager had used data and information from records to continually plan improvement in the quality of care. Events and incidents had been analysed for patterns and trends to ensure lessons were learned and shared with the staff team. The service followed robust arrangements for the confidentiality of data, records and data management systems. The service had implemented relevant quality frameworks based on recognised standards, best practices or equivalents to improve equity in experience and outcomes for people using services and tackle known inequalities. There were computerised systems and processes to assess, monitor and improve the quality and safety of the service provided. There were some inconsistencies within peoples’ documentation regarding changes to health and well-being. This was acknowledged by the manager and immediately actioned to ensure all information regarding people was accurate and up to date. Personal emergency evacuation plans (PEEPS) were on peoples computerised care records, but not available in full in the grab bag used in the event of a fire or emergency evacuation. This was immediately addressed on the site visit. Staff were clear about their roles and responsibilities and had regular individual meetings with the management team which they felt were supportive. Management told us how they monitored and managed staff performance and acted on early indicators to improve skills or conduct. Staff were encouraged to improve their practice through additional training and development of their skills.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.