Downham Grange

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People told us that they are involved in creating and reviewing their care needs. 1 person we spoke with said “I can review my care plan. The nurse went through it with me when I first arrived”

We observed staff supported people on an individual basis and they were in engaged with the person they were supporting and offered them choices and listened to their voices. Actions taken were person-centred and not task orientated.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. We identified where people had refused certain aspects of care that these choices were not always recorded within their care plans and were not risk assessed. Relevant healthcare professionals were not informed, to be assured that the person understood the risks around those decisions and any potential complications.

However, when we spoke to the service about this they acted upon this concern and planned to address the issue and partners felt generally there was a good continuity of care. 1 healthcare professional we spoke with said “Staff notify us of any out-of-hours (OOH) or secondary care involvement, which ensures continuity of care for the people under our care.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Every person we spoke with understood any information that they were provided with. We reviewed the services policies around accessible information standards (AIS) and general data protection regulations (GDPR) these were clear and easy to understand. Peoples care plans from the point of admission recorded how a person communicates, and any adaptions needed to support them. In every persons room there was a service user guide which provides all relevant information about the home and throughout the service there were posters with useful contacts for people.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. Every person we spoke with felt confident in raising concerns and felt they would be addressed. 1 relative we spoke with said “First of all I would go to the manager; and with this new manager she would absolutely take me seriously and really listen to anything I had to say”

We reviewed the services policies around complaints handling, reviewed the services complaints file and found these were appropriately managed. Feedback surveys were conducted and where issues were identified people were spoken with on how to resolve it and learn from it.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Speaking to people in the service they were assured the staff supported them to access care and treatment as required. 1 relative said, “I can speak to any member of staff when he has gone into hospital, they let me know not to come to the home, If he has an opticians’ appointment, they will send someone with him.”

Care records were clear on people’s mobility and sensory requirements required. Where people had complex health needs, they were clear on the actions staff had to take and to be treated urgently and why.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Relatives we spoke with felt people were treated equally and fairly. 1 relative we spoke with said “I think the staff are fair and there is no difference in the way they treat him to other people, I have not observed any discriminatory behaviour by anyone there”

Staff were trained in equality, inclusion and diversity and the service had a policy for staff to follow. All care plans we reviewed recorded the adaptions and support people require to ensure they remained independent as possible and received the same opportunities as others.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Most people that we spoke with informed us that end-of-life care wishes had been discussed, and suitable plans were in place. We reviewed peoples care records and people’s decisions were recorded clearly with plans they had already made or plans they would like to be made.

People had recommended summary plans for emergency care and treatment (ReSPECT) forms in place and recorded people’s individual decisions around Cardiopulmonary resuscitation (CPR) and future hospital admissions. All staff were trained in end-of-life training and some nurses were trained in verification of death training.