Wolston 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 inspection we rated this key question Good. At this inspection the rating has remained the same. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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.

Records showed people’s needs were assessed before they came to the home to ensure their needs could be met. Care plans were developed based on people’s assessed and ongoing needs.

People did not recall initial assessments taking place but explained their family members had likely been involved in this process to help ensure their needs were met. One person said, “They do everything I want them to, if I want something they will do it.”

Staff used care plans and spoke with people about their care to help them meet people’s needs in ways they preferred. For example, care plans included information about people’s preferred communication methods.
 

The provider planned and delivered people’s care and treatment involving them (or their relatives if appropriate). This included what was important and mattered to them. They did this based on evidence-based good practice and standards.

People told us they felt staff knew what they were doing when supporting them. One person said, “They are good, [staff member] is gentle and kind.” People on special diets told us they received meals appropriate to their needs. At lunch time we saw staff encouraged people to eat their meals and when people had cleared their plates, they were asked if they would like some more.

Staff monitored people’s weights, and when they were identified as losing weight, they were referred to other healthcare professionals to help ensure people received the support they needed. One person had been advised by a dietician to have fortified (additional added calorie) snacks between meals. Records demonstrated these were regularly offered. One person required their food to be adapted during times they did not eat well. This was recorded in their care plan and known by staff supporting the person.
 

The provider worked well across team and services to support people. They shared the assessment of people’s needs when people moved between different services.

People said they felt staff worked well together in supporting their needs.

Staff described good teamwork and support for colleagues to ensure people’s needs were met. One staff member said, “To be fair. I think it is quite good. Some staff are still learning. Other staff are really experienced. I think we have got a good team here.” Staff told us information about people was shared verbally and through the handheld electronic devices between each shift.

A GP completed a ward round at the home every week and spoke positively of working with the home.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, to reduce their future needs for care and support.

People told us about decisions they made with staff to help them with their wellbeing and to remain independent. One person said, “I say what I want to do and if I don’t want to do something.” They also told us, “They are good at getting the doctor.”

People’s care plans advised what support people needed to maintain their health including oral care. People had access to a visiting GP and other health professionals including district nurses and a dentist to support them with any issues relating to their health.

Staff said they were able to provide care in a way that supported people to lead healthy lives. This included supporting people with specialised diets designed to manage their weight and prevent them from choking. Staff told us they supported people to attend health appointments when needed.
 

The provider had arrangements in place to monitor people’s care and treatment to continuously improve it. Outcomes were not always consistently recorded to show they met clinical expectations.

Records to monitor people’s care and support were not always completed accurately to demonstrate safe practice and enable effective monitoring to take place. For example, there were limited entries on fluid intake charts for those at risk of not drinking enough. There were also limited entries on repositioning charts for people at risk of skin damage, and bowel charts for people at risk of constipation. Despite this, we did not find that people had experienced ongoing poor outcomes. Where people could demonstrate distress and anxiety, this was being recorded so information could be shared with other healthcare professionals involved in people’s care.

People felt that staff knew about their care and recognised when they may need additional support.
 

The provider worked with people to ensure their rights were protected and their consent obtained when delivering person-centred care and treatment.

People’s needs were assessed and planned for. People said they were able to make choices about their daily lives and were asked for their consent before providing care. One person said, “They knock on the door and say good morning, would you like a wash.” We saw that when staff offered people choices, they did not rush them to make a decision.

People’s capacity to consent had been assessed, and people were involved in planning their care and support. Where a person's capacity to understand information related to their care and support was questionable, care plans included a mental capacity assessment relating to the decision that needed to be made. Capacity assessments contained information about how people had been supported to make the decision. For example, 1 person had been given information about the decision to be made in their native language.

Staff worked with healthcare professionals to monitor people’s health and wellbeing, and people were supported with access to an advocate if requested. Staff offered people choices and understood people had the right to decline support if they wished to. Staff told us if people declined care, they would respect this but would provide an opportunity for them to reconsider their choice at a later stage. One staff member told us, “This morning [Name] has declined. They asked me to come back in an hour. I took them some fresh flannels and towels and said I would come back in an hour and documented that on the system. It is all about choice at the end of the day.”