Spencefield Grange

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Relatives told us they were involved in assessing and planning for their loved one’s care and support needs. One relative told us, “The manager spoke with me and my [relative] during the care planning process when arranging their care and with a senior carer.” Completed assessments were used to help create care plans which outlined people’s care and support needs. Care plans were regularly reviewed to reflect any changes in people’s needs and health conditions. Care plans and assessments included information about people's histories, communication needs and how they wanted to be supported. One staff member told us, “They have the care plan which tells us their background and what they require. We get told what they like and what they don’t.” This meant people were supported effectively by staff who were aware of their needs and understood how care and support should be provided.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People's nutrition, hydration, and preferences were met. Recognised clinical assessment tools were used to assess and review people’s care and support needs, such as skin care, dietary and hydration needs. Most people and their relatives told us they enjoyed the food and menus on offer. A person told us, “It’s ample. It tastes alright.” However, 1 person said, “It’s a bit samey and bland.” We observed how people were supported at lunch time in the dining areas and other parts of the service. Where people required support from staff to eat their meals safely, we observed that support was provided appropriately and with dignity. The chef and kitchen staff were knowledgeable about people’s dietary needs and daily menus offered choice. This meant people received food choices that were safe and appropriate for them, and followed national guidance.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff communicated effectively with other professionals. These included the local authority, regular GP and district nursing staff. We saw staff made referrals when people required medical healthcare and treatment and when staff needed advice and information for changes in people’s conditions. One relative told us, “[Relative] has had a history of falls and has been seen by an OT (occupational therapist) who changed her from using a zimmer to a stick which is much safer. No falls since.” An external health care professional said, “Communication is effective and robust, and we have clear methods for communication in both directions for routine and urgent issues.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People’s health conditions were assessed and monitored using recognised clinical tools. Care plans provided staff with guidance about how to provide effective care and support. Health needs were monitored. For example, people who were at risk of pressure injury to their skin received regular care interventions which included regular repositioning to maximise and encourage blood circulation. People and their relatives told us they had access to health care professionals when required. One person said, “I just tell staff, and they get me to see a doctor.” A relative said, “I am kept up to date with any concerns regarding [relative’s] health needs and a doctor visits every Monday.” Another relative told us, “Any appointments get arranged, chiropody, hairdresser, GP and optician.” People’s health needs were assessed and care plans documented how best people should be supported. 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People’s care and health was monitored by the staff who knew when to escalate concerns. Staff told us, “This morning we had a person whose urine is very strong and dark. We have sent a sample to the GP and if they don’t pass any urine, we will need to phone the GP or 111.” The provider had robust systems and processes that monitored clinical care outcomes. For example, people at risk of malnutrition had their dietary intake and weight monitored. If people had unplanned weight loss this was identified and investigated, and a plan was put in place to prevent further weight loss if required.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider worked within the principles of the Mental Capacity Act 2005 (MCA). Systems were in place to ensure mental capacity assessments were completed when necessary. If people could not make decisions or consent to their care, processes were in place to ensure decisions were made in their best interests, involving all relevant persons. Staff were trained on the MCA and knowledgeable about people’s rights regarding consenting to care and treatment. One staff member told us, “We do mental capacity assessments and best interests, we communicate with advocates, the local authority, social worker, to make sure measures are in place to make sure all decisions are least restrictive and the best outcome for them.”