The inspection took place on 24 May 2017. The inspection was unannounced.

The Grange care home is a residential care home based in Darlington, County Durham. The home provides personal care for older people and people with dementia. It is situated close to the local amenities and transport links. The home is registered for up to 74 people and on the day of our inspection there were 68 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 service had not been rated under the new registered provider of Burlington Care Limited so this was a first rated inspection for The Grange Care Home.

The atmosphere of the service was homely and very welcoming.

People who used the service and their relatives that we spoke with told us they were satisfied with the service.

We saw staff interacting with people in a caring and attentive way.

We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness.

We saw that people were encouraged to enhance their wellbeing and take part in activities.

We spoke with a range of different team members; care, kitchen staff and activity staff, who told us they all felt well supported and that the registered manager was supportive, and they were all polite, receptive, open and approachable. We also spoke with visiting professionals from the community nursing team.

Throughout the day we saw that people who used the service, relatives and staff were comfortable, relaxed and had a positive rapport with the registered manager and also with each other.

From looking at people’s care plans we saw they were written in plain English and in a person centred way. They also included a ‘life map’ that made use of personal history and the plans described individuals care, treatment and support needs.

Care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm.

People’s health was monitored and referrals were made to other health care professionals where necessary, for example their GP, community nurse or dentist.

People who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.

Staff had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs.

Robust recruitment processes were in place.

We observed how the service administered medicines and how they did this safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and we found that the process was safe.

People were encouraged to eat and drink sufficient amounts to meet their needs. Drinks were out for people and we observed people being offered a varied selection of drinks and snacks.

People and their relatives were knowledgeable about the complaints and compliments procedure that was in place.

People also had their rights respected and access to advocacy services if needed.

The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found.

People who used the service and their representatives were regularly asked for their views about the care and service they received at meetings and via surveys. Views were then taken on board using a ‘you said we did’ system.