This comprehensive rated inspection took place on 18 December 2018 and was unannounced. It was the first rated inspection of the service under the provider Indigo Care Services (2) Limited, which registered Grimsby Grange and Manor as a new location in December 2017. The service had previously been registered as two separate locations.

Grimsby Grange and Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Grimsby Grange and Manor is a large service set over three floors in two buildings and can support a maximum of 94 people with a range of health care needs. Some people who used the service were living with dementia and parts of the service were more equipped to meet their needs. All the bedrooms are for single use and all have en-suite facilities. There are communal rooms, bathrooms and toilets on each floor suitable for people’s diverse needs. At the time of the inspection, there were 34 people accommodated in Grimsby Manor and 24 people in Grimsby Grange.

There was not a registered manager for the service. A registered manager is a person who has registered with the CQC 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. The previous registered manager had left the service in October 2018 and a new manager had been recruited before that time to work with them and receive an effective handover. The new manager was experienced and had applied to register with CQC.

This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This included support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.

People told us they felt safe and staff knew how to keep them safe from harm and abuse. Staff completed safeguarding training and could describe the action they would take if they had concerns. Staff completed assessments to help minimise risks to people. There were sufficient staff deployed to meet people’s needs and they were recruited in a safe way. Medicines were managed safely and people received them as prescribed. Improvements had been made with the standards of hygiene and the planned refurbishment further maintained this.

People’s health and nutritional needs were met. Staff ensured people had access, in a timely way, to a range of health care professionals for advice and treatment when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff received training, support and supervision to enable them to feel skilled and confident when supporting people. The environment had been adjusted to take account of people’s differing needs. This included prominent signage and colour-contrasting equipment to increase visibility for people living with dementia.

People told us staff had a kind and caring approach. We observed this throughout the inspection and it was confirmed in discussions with relatives and professional visitors to the service. Staff provided people with explanations and information in accessible formats such as pictorial signs and symbols. People’s privacy and dignity were respected and supported.

People received personalised care and support they needed in the way they preferred. Staff took the time to get to know people and their life and soci