The Grange Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in breach of the legal regulations relating to safe care and treatment, premises and environment, and good governance.

This service scored 44 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Lessons were not learnt to continually identify and embed good practice. Accidents, incidents and falls were reported by staff, however they were not consistently reviewed by management. Audits of accidents, incidents and falls were not robust and failed to identify themes and trends to mitigate risk. For example, falls audits had not identified a need to review a person’s care plan, risk assessment or make a referral to the falls team. This placed people at risk of harm. However, people using the service told us they felt safe. One person told us, “I have had no falls since being here, I am independent really, but I do always have a staff member to support me when needed.” And, “I can talk to staff if I feel unsafe.”

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

Risks to people were not always robustly assessed or mitigated. We found care plans and risk assessments that had not been reviewed regularly, or as people’s needs changed. For example, a person’s falls risk assessment had not been reviewed in 5 months despite them experiencing falls. This placed people at risk of receiving unsafe care. People were not always supported in line with their assessed needs. For example, one person required support from 1 staff when walking but was observed during our inspection to walk without support. Furthermore, records were not always completed to show people had been provided with enough to drink. This placed people at risk of health deterioration. However, a visiting professional told us they felt assured staff knew people’s needs well and reported no concerns about safety.

Risks to people were not always robustly assessed or mitigated. We found care plans and risk assessments that had not been reviewed regularly, or as people’s needs changed. For example, a person’s falls risk assessment had not been reviewed in 5 months despite them experiencing falls. This placed people at risk of receiving unsafe care. People were not always supported in line with their assessed needs. For example, one person required support from 1 staff when walking but was observed during our inspection to walk without support. Furthermore, records were not always completed to show people had been provided with enough to drink. This placed people at risk of health deterioration. However, a visiting professional told us they felt assured staff knew people’s needs well and reported no concerns about safety.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

During our on-site inspection, we identified some areas and furniture within the service which required further cleaning. Cleaning schedules did not always show there were clear actions and responsibilities around infection prevention and control (IPC). For example, cleaning schedules were not always fully completed. Whilst staff could tell us why some areas within the service had not been cleaned that day, for example people had declined to have their room cleaned, this was not recorded. However, most areas and equipment within the service were clean. Domestic staff were appropriately trained and knowledgeable in their roles. People fed back positively on the cleaning standards at the service. People were observed to be clean and supported to maintain good personal hygiene. Staff followed best practice guidance in relation to wearing personal protective equipment and relevant policies were in place to support staff in IPC.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.