Our inspection of Grange Court Residential Home took place on 31 October 2017 and was unannounced. This was the first inspection since the service had re-registered under a new legal entity.

Grange Court is registered to provide accommodation and personal care for up to 30 people. The home is situated in a residential area of Baildon, a few miles from Shipley town centre. There is a large lounge area, a conservatory, two dining rooms, and bedrooms situated on the ground and first floor as well as enclosed garden areas. At the time of our inspection there were 26 people living at the service.

A registered manager was in place. 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.

Staff had received training on how to keep people safe and understood how to recognise and act on signs of abuse. Appropriate safeguarding referrals had been made and incidents/accidents were documented with actions taken. People had assessments in place to mitigate risk which were up to date. Some people's personal emergency evacuation plans needed to reflect current mobility needs.

Medicines were mostly managed safely and people received their medicines when required. Greater care needed to be taken to correctly record medicines stock amounts such as Paracetamol. The medicines trolley was left unattended and unlocked on one occasion during the administration of medicines in the dining room when a number of people were present.

Staff were recruited safely and sufficient staff were deployed to keep people safe although some concerns were expressed by staff, people and relatives about staffing levels at night time. Training was in place to ensure staff were kept updated and people told us staff knew what they were doing. Staff were kind and gentle with people and we saw good relationships had been developed. People told us they felt safe living at the home and looked comfortable in staff presence.

The service was operating within the legal requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). People's consent was requested for care and support and documented decisions made in people's best interests.

Care records were person centred and specific with good attention to detail. Reviews of people's care records needed to evidence involvement with people and/or relatives. People's end of life wishes were recorded and advanced care planning in place as required.

The service used assistive technology to assist with people's healthcare needs as well as allow people to communicate with relatives who lived abroad.

Activities reflected the wishes and interests of the people living at the home. People's choices were respected and independence promoted wherever possible. Relatives were welcomed warmly and staff clearly knew people and their relatives well.

Any complaints were treated seriously and investigated with outcomes documented. A number of compliments had been received by the service.

Relatives and healthcare professionals told us communication from the service was good.

People received a well-balanced and nutritional diet and any concerns with people's weight or food/fluid intake was referred to the GP. Food and fluid charts were completed and nutritional supplements in place where required.

The culture of the service was open and transparent with staff and the management team passionate about making a difference to the lives of people living at the service. The registered manager was a visible presence within the home and led by example.

A range of quality audits were in place to monitor and drive improvements within the service. People's voices were listened to through meetings and surveys, with actions taken as a result.