Archived: Grange Cottage

Grange Cottage provides care and accommodation for up to nine people who need personal care. The home is situated in the small town of Grange over Sands on the coast of Morecambe Bay. The property is a large six bedroom cottage, five with ensuite facilities. There are three one bedroom ensuite rooms in a bungalow in the adjoining garden. The property has been adapted and extended for its current use as a care home.

At the time of our inspection there were six people living in the home.

There was a registered manager employed. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last focused inspection of this home on 26 November 2015, we asked the provider to take action to make improvements to staffing, staff training, staff recruitment processes, how medicines were managed and fire safety. Following the inspection the registered manager took immediate action to protect people from the risk of harm. They also wrote to us detailing the actions they had taken and planned to take to ensure the quality and safety of the service.

At our inspection on 8 July 2016 we found these actions had been completed. The processes used when new staff were employed had been improved, there were enough staff to care for people and all staff had completed appropriate training. Medicines were managed safely and people had been protected against the risk of fire.

We saw that people were treated with kindness, patience and respect. They made choices about their lives and the decisions they made were respected.

People were safe living in the home. They were protected against abuse and avoidable harm. Hazards to their safety had been identified and action taken to manage the risks identified.

People were provided with a choice of meals and drinks that they enjoyed. Activities were provided to take account of people’s interests and preferences.

There were enough staff, with the skills and knowledge, to provide the support people needed. The staff knew people well and provided their support as they wanted.

People were supported to access appropriate health care services to ensure they maintained good health.

Visitors were made welcome in the home and people could maintain relationships that were important to them.

The registered manager worked with the staff in the home providing guidance and overseeing the quality of the service. People knew the registered manager and were comfortable speaking to her. They knew how they could raise concerns and were confident action would be taken if they did so.

People were asked for their views and were included in developing how the service was provided.

After the comprehensive inspection, the registered provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this unannounced focused inspection on 26 November 2015 to check that the registered provider had followed their plan and to confirm if they now met legal requirements.

During our focused inspection we also identified new areas of concern around fire safety, safe handling of medicines and the competence of people working in the home. This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Grange Cottage on our website at www.cqc.org.uk.

We found that improvements had been made to the processes used when new staff were employed, however some of the information required by law had not been obtained for one new member of staff. We also found that, although care staff had received training to meet people’s needs, the registered provider and a person who supported the night care staff had not completed any training. This meant the registered provider continued to be in breach of the regulations relating to training and to staff recruitment.

People had given formal consent to the care they received and we saw that the care staff respected the choices people made about their support. The registered provider had taken action to meet legal requirements regarding obtaining consent from people.

Grange Cottage provides care and accommodation for up to nine people who need personal care. The home is situated in the small town of Grange Over Sands on the coast of Morecambe Bay. The property is a large six bedroom cottage, five with ensuite facilities. There are three one bedroom ensuite rooms in a bungalow in the adjoining garden. The property has been adapted and extended for its current use as a care home.

There was a registered manager employed in the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us that they felt safe living in this home. They said they usually received support from care staff who knew the care they required and how they wanted this to be provided.

People followed a range of activities in the local community that they enjoyed.

People were placed at risk because medicines were not always handled safely. People had not always received their medicines as their doctor had prescribed.

People were not protected against the risk of fire. Fire hazards had not been identified and fire safety procedures were not always followed.

People who lived in the home could not be confident that they would receive the support they needed or their care safely when the registered provider worked as the night staff member.

We discussed the issues we found with the registered manager of the home. They took immediate action to safeguard people from further risk including ensuring people were protected from the risk of fire and by removing untrained individuals from delivering care.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe handling of medicines, protecting people from the risk of fire, ensuring people delivering care were trained and competent and in staff recruitment. You can see what action we told the provider to take at the back of the full version of the report.

People told us,

'The staff are all very nice, they're friendly and kind',

'It's really very nice here',

And said, '[The manager] really wants you to know she's there for you, she discusses everything with us'.

One person told us they were 'very pleased' with their room and someone else told us, 'I do what I want here, no-one tries to tell me what to do.'

We observed that the staff on duty were knowledgeable about the support people needed and about individuals' preferences regarding their care.

We found that there were concerns regarding the security of the home and fire safety. During our inspection we found times when the main door to the premises was left unlocked and we saw that one of the fire exits was not fitted with an appropriate lock.