Rothsay 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 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.

Pre-admission assessments were face to face and person centred. Staff carrying out the assessments obtained information related to people‘s needs, including information relating to their medical history, mobility, nutritional needs and people’s communication needs. One person’s relative said, “We had a meeting with social services, and a report was sent through to the care home and [staff name] discussed it with my brother and I. [Staff name] was very positive and optimistic of how [relative] would settle in. [Staff name] was realistic but put our minds at rest and said, ‘This is the care plan and as time goes on, we will tweak and adjust it as necessary.’ It felt collaborative. [Staff name] had also met [relative] and knew about [relative] and had shown an interest, so, we knew that [staff name] had read and retained the information about [relative’s] life.”

Staff told us they had access to sufficient information before people started using the service. One staff member said, “We have a morning handover where we will be told about any people moving in or anyone going to hospital. There is also a huddle at 2pm to update us on anything new. Residents most essential information is given to us and in their care plans before they arrive. On their first day in the home, carers will do their weight and find out their likes and dislikes.”

Records showed people’s needs were reassessed regularly and most people’s relatives told us they were invited to discuss these reviews over the phone. Some people’s relatives told us they had seen their family member’s care plan. One person’s relative said, “They [staff] discussed the care plan with us. It was very good and thorough, and they went through it with all the family.”

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.

The environment was not consistently dementia friendly, especially on Memory Lane, a unit specifically for people with dementia. The service had sought internal support from their own dementia team, reviews had been carried out, and an action plan was in place. A staff member said, “We've created corners throughout the home, where people can sit to be quiet if they want to. We’ve got a mobile device that makes bird sounds, and we’ve found it helps to create a calm environment for people.” After the inspection the manager told us they had ordered some memory boxes to be put outside people’s bedrooms to help people identify their own rooms, as well as some other dementia friendly items.

Nationally recognised tools were used to assess and monitor people’s needs and risks.

Kitchen staff knew people’s dietary needs and preferences and were trained to carry out their roles. They told us how they were kept informed about people’s changing needs. We observed lunch during the inspection. This was a sociable occasion. We observed staff guiding people to their seats and asking them what they would like to drink. Tables were set with linen tablecloths, placemats, cutlery, glasses and menus and we saw staff chat to people as they arrived. Easy listening music was playing in the background. Staff used people’s names as they asked them for their choice of food and served them. The staff used ‘show plates’ for some people. Show plates provide a visual cue and an alternative to reading a menu, helping to promote independence and a sense of control, particularly for people with dementia.

The chef told us they attended monthly meetings to seek feedback from people about the menu. They said they made changes based on people’s preferences. They told us, “If someone asked for fillet steak for a special occasion I can get it. In fact, we did this for one person not that long ago. They wanted steak and chips, and they had steak and chips.” The kitchen staff had also made pureed birthday cakes for those people with difficulties swallowing.

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.

The service had good links with other health professionals. The GP visited the service weekly and records were kept when health professionals visited, and any advice they gave. One health professional told us staff were knowledgeable and made appropriate referrals. They said, “[Staff name] is knowledgeable about wounds and all the residents.”

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 they were supported to attend medical appointments and that when they were unwell staff sought medical advice. One person’s relative said, “[Name] was rushed to hospital a few weeks ago. I was here in the room and noticed [name] was unwell. I called the nurse, and they came straightaway and phoned the ambulance. They reacted very quickly. I was very impressed.”

There was effective oversight of people’s wellbeing and staff told us they referred people for additional advice and support when required. Records showed concerns were acted on. For example, when people lost weight, the GP was informed, and people were supported with food supplements and a fortified diet. The chef told us “We go to the clinical governance meetings and get sent the report. If someone loses weight, we make fortified food and drinks for them, a favourite is peanut butter smoothies.”

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 was oversight of people’s needs in place. Clinical governance meetings took place monthly and any wounds and weight loss for example, were monitored and analysed. People’s relatives told us their loved ones were well looked after. One person’s relative said “[Staff name] is very good, right on the button. I can ask anything about my relative’s health and [staff name] is on it.”

Referrals were made for people who required additional clinical support, such as the tissue viability nurse, the older people’s mental health team and speech and language therapy (SALT).

Some people told us they attended an exercise class to support mobility and strength. The service had good links with a local mobility team and physiotherapists to improve outcomes.

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

Throughout the inspection we saw and heard staff ask people for their consent. For example, we saw staff knock on people’s bedroom doors before entering.

People and their relatives told us staff respected their choices. One person said, “If I want a shower for example, I just ask, and they try and fit it in.”

Mental capacity assessments were carried out in line with legislation and best interest decision making procedures were in place and were followed. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care services, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with DoLS. This meant people’s rights were fully respected. The deputy manager kept a record and tracker of DoLS applications and authorisations.