About the service:

The Grange Nursing and Residential Home is a care home that provides personal care for up to 50 older people, some of whom are living with dementia. At the time of our inspection, there were 34 people using the service.

People’s experience of using this service:

¿ Governance systems and audits were not always effective in identifying issues and where improvements were needed.

¿ Improvements were required to medicines record keeping.

¿ There were sufficient staff to meet people’s needs, but support given was task-focussed and not always timely.

¿ Improvements were required with regards to retaining proof of staff identity and risk assessments when recruiting staff.

¿ Improvements were required to environmental risk assessment and management, particularly with regard to needs of people living with dementia.

¿ People were supported to have an adequate diet but this was lacking in choice.

¿ People’s needs were assessed before being admitted to the service. Plans of care were in place with an action plan in place to develop a more person-centred approach.

¿ The principles of the Mental Capacity Act (MCA) 2005 were followed. However, improvements were required to MCA and best interest decision record keeping.

¿ Staff were kind and caring. People’s independence and privacy was supported but people’s dignity and confidentiality was not always considered or respected.

¿ People’s access to activities was limited. This had been recognised and action taken to recruit activities staff to improve people’s access to activity.

¿ Healthcare needs were met, and people had access to health professionals as required.

¿ People told us they felt safe living at the service. Staff were aware of their responsibilities for keeping people safe and had received the relevant safeguarding training.

¿ Staff were supervised and felt supported by the management team.

¿ A complaint’s system was in place and used effectively.

¿ The environment was in the process of being refurbished. However, we recommend that the provider finds out more about the environment for people living with dementia, based on current best practice.

Rating at last inspection:

This was the first inspection of the service. The service was registered on 14th May 2018.

Why we inspected:

This inspection was carried out earlier than scheduled in response to concerns that people were receiving poor quality care.

Enforcement:

At this inspection we found the provider to be in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Action we told provider to take is recorded at the end of the report.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk