Grosvenor House

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.

Before people moved into the home an assessment of their needs was completed to ensure these could be met at the home. People and their relatives were involved in these decisions and discussions about care needs. People’s needs were continually reviewed. Their care plans and risk assessments were updated as their needs and preferences changed. Staff were aware of people’s needs, and this ensured appropriate care and support was 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.

Records showed the use of nationally recognised tools for example, the Waterlow score for assessing people’s risk of pressure damage and the Malnutrition Universal Screening Tool (MUST) for monitoring people’s weight. Where risks were identified appropriate actions had been taken to ensure people’s needs were met.

Staff received regular training and updates to help ensure they understood the current standards of care to support people effectively. Staff demonstrated a good understanding of how people’s health and social care needs impacted upon their lives and what they needed to do to be able to deliver effective support. Staff had access to provider policies to support their understanding of current good practice guidelines.

People’s care and support needs were regularly reviewed, and staff were aware of any changes.

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 told us, and records showed, information about referrals and ongoing discussions that had taken place regarding people’s health and social care needs. Staff told us they worked together as a team to ensure people received the care and support they needed. One staff member said, “We’re a good team, we know what is going on.” Staff were updated at each handover about changes to people’s needs. Staff were allocated the people they were to care for at the start of each shift. They were responsible for ensuring people’s needs were met, care plans were updated and daily records completed. This provided a structure for staff each day.

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.

People and their relatives told us if they had any health concerns staff would ensure they received the appropriate support. People told us the local GP contacted the home each week and staff would discuss any health concerns with them. However, people told us if they wanted to see a GP, they had to visit the surgery. One person said, “We have a doctor down the road, staff take me in a wheelchair. Staff will make an appointment for me if I ask.”

Staff understood people’s health needs and when to contact the relevant health professionals. There was a weekly, virtual ‘ward round’ by the local GP. This is when the GP contacts the home to discuss the medical needs of people who live there. They identify where people’s needs have changed and may need further support from medical services. For example, following a fall or after a hospital admission. Further referrals were made to external healthcare services where required. These included speech and language therapists, dietitians and occupational therapists.

The registered manager and staff told us people were supported by the community nursing team with regular visits for guidance and support. People were supported to maintain good health and attend regular health appointments including the dentist, optician and chiropodist

People’s medicines were reviewed by the GP and community pharmacy team to ensure they continued to be appropriate for people’s needs. People’s care plans contained information about people’s health and well-being needs. These were reviewed and updated. They provided guidance for staff about how to support, maintain and improve people’s health. Health care professionals told us people were referred for health advice appropriately and guidance was followed.

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.

There were systems in place to monitor people’s care and support to improve outcomes and ensure the appropriate care was being provided. One person told us about the improvements they had made since moving into the home. They said, “I came here in a wheelchair and after 4 weeks was using a Zimmer frame and I now go downstairs on my own.” Staff told us about improvements people had made after moving into the home. This included weight gain which reduced people’s risk of malnutrition and dehydration. Some people’s mobility had also improved which meant they were able to walk independently around the home.

Staff knew people well and monitored them throughout each day, they were able to identify changes in people’s health and well-being. People’s weight was checked to identify if there was any unexpected weight loss. People’s weights were shared with the GP each month to ensure they also had oversight of any changes that may require treatment. Where other observations had been recorded, for example, blood pressure or blood sugar levels these were also shared with the GP and other relevant healthcare professionals. People’s skin integrity was monitored to identify pressure damage or wounds. Records were maintained of care and support provided, such as personal hygiene and dietary intake.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Where people were deemed not to have capacity, mental capacity assessments had been developed and recorded in a decision specific way. These demonstrated the involvement of people, their relatives and how decisions were made in people’s best interests.

Staff told us people were able to make their own decisions and choices and how they supported them to do this, for example by showing pictures of food to help with meal choices. They told us some people made, what could be considered, unwise decisions about their care and support. Staff told us how they respected people’s decisions and measures they put in place to ensure the person remained safe. Staff received MCA training. Throughout our visit we observed staff asking people’s consent and offering choices before they provided care and support.