The Grange Nursing Home

Updated 20 December 2018

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 was 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.

This inspection took place on 2 and 8 November 2018. The first day of the inspection was unannounced and was carried out by one inspector. The second day of the inspection was announced and was carried out by one inspector and a nursing advisor who specialised in the care of older people.

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We used information the provider submitted in their Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with six people who lived at the home and four relatives. We spoke with the registered manager and seven staff, including nursing, care, activities, housekeeping and catering staff. We observed the care people received, their mealtime experience and the interactions they had with staff.

We checked the care records of three people, including their assessments, care plans and risk assessments. We looked at how falls were managed and assessed whether any equipment used in people’s care was appropriate for their needs. We checked the management of medicines. We looked at four staff recruitment files and records related to staff support and training. We checked meeting minutes and how complaints were managed.

Updated 20 December 2018

This inspection took place on 2 and 8 November 2018. The first day of the inspection was unannounced.

The Grange Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home can accommodate a maximum of 24 older people, some of whom may be living with dementia. There were 23 people living at the home at the time of our inspection.

At our last inspection in February 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Why the service is rated Good.

People felt safe and secure at the home. Staff were always available when people needed them, which meant people did not have to wait for their care. Staff understood their role in keeping people safe and were aware of their responsibilities should they suspect abuse was taking place. People were protected by the provider’s recruitment procedures.

Any risks involved in people’s care were identified through assessment and action taken to minimise them. Medicines were managed safely. Health and safety checks were carried out to keep the premises and equipment safe for use. The home was clean and hygienic and staff maintained appropriate standards of infection control. There were plans in place to ensure people would continue to receive their care in the event of an emergency.

People’s needs were assessed before they moved into the home and kept under review. Staff encouraged people to make decisions in their day-to-day lives and respected their choices. People’s care was provided in line with the Mental Capacity Act (2005).

Staff had the induction, training and support they needed to perform their roles. All staff had an induction when they started work and access to ongoing training relevant to the needs of the people they cared for. Staff attended regular one-to-one supervision with their line managers, which gave them the opportunity to discuss their training and development needs.

People enjoyed the food provided at the home and were supported to maintain adequate nutrition and hydration. Staff monitored people’s health and supported them to obtain treatment if they needed it. Referrals were made to healthcare professionals if staff identified concerns about people’s health or well-being.

The design and layout of the home was suitable for people’s needs. People were able to personalise their bedrooms to reflect their individual tastes and preferences. People were supported to maintain their independence where this was important to them.

Staff were kind and caring. They treated people with respect and maintained their dignity when providing their care. Relatives told us they and their family members valued the family atmosphere the home provided.

People enjoyed the activities provided and had opportunities to engage with others from their local community. Staff ensured that people who did not participate in group activities were protected from social isolation.

People and their relatives were encouraged to give feedback about the home and their views were listened to. People knew how to complain and were confident that any concerns they raised would be addressed. Any complaints received were investigated and used to improve the service.

People received care that was responsive to their needs. Care plans were personalised and recorded people’s preferences about their care, including the care they received towards the end of their lives.

The home had a committed registered manager who provided good support to people, relatives and staff. The registered manager ensured their own skills and knowledge were maintained and was aware of their responsibilities in terms of reporting notifiable events when they occurred.

Staff had developed effective working relationships with other professionals involved in people’s care. Key aspects of the service were audited regularly, which ensured that people received safe and effective care.

Further information is in the detailed findings below.