The Grange Nursing Home

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 good. At this assessment the rating has remained 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 and their family members had been encouraged to contribute to people’s pre-admission assessments. One relative said, “[Previous manager] went to the hospital to visit [family member] before transfer, then [manager] invited me to discuss everything with her at the home, including all [family member’s] likes and dislikes.” Another relative told us, “We had a sit down home visit and I had the opportunity to talk about how [family member] would like to be looked after, and they have implemented everything we talked about.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them.

People's care was planned and delivered in a way which reflected best practice guidance and standards. Staff worked closely with other professionals to assess and plan for people's needs, and to monitor these to help ensure people stayed healthy and well.

The manager ensured staff had access to information about good practice and how to provide effective, evidence-based care. Staff told us they received the support they needed to understand and implement this.

People's nutrition and hydration needs were met. The chef understood people’s individual dietary needs and preferences, and planned the menu to take account of these. Relatives whose family members were reluctant to eat and/or drink said staff encouraged them to do so and monitored their weight and fluid intake, taking action if any concerns were identified.

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 worked well together to ensure people’s needs were met. Staff said they supported one another well and that there was a good sense of teamwork at the home.

Staff shared information about people’s needs effectively, including when their needs changed. Information about any changes to people’s care and support was shared at daily handovers. A member of staff who had recently joined the team told us their induction had included shadowing colleagues to understand people’s needs and preferences.

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, reduce their future needs for care and support.

Staff ensured people had access to healthcare and treatment when they needed it. This included making referrals to other professionals when necessary. One relative told us, “[Family member] complained of lower back pain and the home was very quick to refer to the doctor, who sent her off to X-ray with transport and an escort. The outcomes were sent to me directly by the hospital and copied to the home. It was very efficient.”

Relatives told us staff were observant of any changes in their family member’s health or wellbeing because they knew them very well. One relative said of staff, “They are so caring, and they know [family member] so well that if anything is not quite right, they spot it right away.”

The provider 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.

Relatives said their family members’ health was monitored effectively by staff and visiting professionals. One relative told us, “They have a doctor visiting each week, then they have a dentist going in regularly, a chiropodist, an optician, and they come in to do the ‘flu and COVID jabs. The home always lets us know.” Another relative said of staff, “They absolutely do their best, they monitor [family member] well and called an ambulance in good time when it was needed.”

We saw evidence that referrals were made to specialist healthcare professionals when necessary to ensure people’s needs were met. For example, a referral had been made to the speech and language therapy team for a person who had developed difficulties in swallowing.

The provider respected people’s rights around consent and their decisions about their care and treatment. Staff understood the need to seek people’s consent on a daily basis before providing their care.

The manager ensured people had appropriate representation when decisions about their care were being made. People’s families were encouraged to attend any assessments or reviews and to contribute their views. For one person who had no immediate family, the manager had arranged an independent mental capacity advocate (IMCA) to attend a decision-making meeting.

Applications for DoLS authorisations had been submitted where people were subject to restrictions for their own safety, such as being unable to leave the home unaccompanied.

DoLS stands for Deprivation of Liberty Safeguards, a legal framework designed to protect people who lack mental capacity in care homes or hospitals from being deprived of their liberty without proper authorisation.These safeguards ensure that any restrictions on a person's freedom are necessary, proportionate, and in their best interests.