Downham 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 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 67 (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 did not always make sure people’s care and treatment were effective. We identified that care plans were not always accurate and had contradicting information recorded in them. Care plans recorded different times for when a person should be checked on to ensure they were safe, we identified this in several care plans. They did not consistently reflect a person’s care and support needs accurately

We reviewed the services resident of the day process, and this evidenced people, and their relatives were involved in reviewing their care needs on a regular basis. When we spoke to 1 relative they said “I am always involved, they review her needs, they will call me for meetings about her wellbeing, how she is eating, and they do ask if I have any input”

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 expressed how they are offered a variety of food and drink in the service to help prevent malnutrition and dehydration and staff make them aware of risks and best practice guidance to follow.

Staff informed us of the clinical tools they use to assess a person’s health and the purpose of them. We reviewed the services processes, and we noted when a person had a specific health-need that their care plan reflected the national institute for health and care excellence (NICE) guidance for staff to follow.

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. People we spoke to felt there was a good working relationship between staff in the service and external partners. Staff informed us of the communication within the service and how it works well.

When we spoke to partners about the information they received of people in the service they said, “The information that staff are able to share with us regarding people who have been referred appears accurate, relevant and up to date.” We reviewed care records, and we could see regular involvement from healthcare professionals.

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 informed us that they had a choice of nutritious meals to choose from, 1 person we spoke with said “I love the fact they have a chef who cooks fresh daily. Prior to coming here, I was eating frozen meals. The meals here are lovely”

Staff we spoke with explained how they supported people to live healthier lives by monitoring their health, using clinical tools on a regular basis or when there were concerns over an individual. They encouraged a variety of snacks throughout the day in addition to offering nutritious meals. They asked for people’s feedback regularly on the food they ate and ensured there was a variety of different activities provided.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that they met both clinical expectations and the expectations of people themselves. We reviewed peoples care records and noted a discrepancy in fluid entries. The service informed us it was a duplication on their system. This did not assure us that the records were a true reflection of what people in the service were drinking and no additional checks were being carried out to review charts to ensure they were accurate.

However, people were involved in the review of their care records and were encouraged to set goals or targets on how they wished to improve their health and well-being. This was a mixture of emotional, social and health targets. Staff we spoke with explained how they support people to improve their health, 1 staff member said, “It's nice to see someone come in immobile and then we get them back on their feet and moving again with support from Occupational Therapists.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People we spoke with explained how staff are polite and gain consent before doing anything. Where people lacked capacity, their families were involved in the decision making. We spoke to 1 relative who said, “He does not make any decisions, and I am involved in any decision making around his care and planning.”

Staff told us how they always obtain consent prior to carrying out any task. We reviewed the services policies around consent and reviewed peoples consent forms. Where people lacked capacity, we reviewed their capacity assessments, and they were clear and concise. The service ensured they had seen evidence of lasting power of attorneys records where applicable and held copies onsite.