Larchwood Grove

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.

This is the first assessment for this newly registered service. This key question has been ratedrequires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care and treatment.

This service scored 62 (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.

People had their needs assessed before moving to the service. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. The assessment included making sure that support was planned for people’s diversity needs, such as their gender, culture and their abilities. Some people were able to recall being involved in their assessments and care planning process. Relatives told us they had been involved in the care planning process.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People had choices of food which met their assessed needs. However, people were not always able to have drinks of their choice when they wanted it. We observed 1 person ask staff several times for a cup of tea between 10:25 and 10:45. They were told by staff that it was not time to have a cup of tea, and they could have it at 11:00. We reported this to the registered manager as a concern as people did not have freedom to have a hot drink when they wanted one. They told us people could have a drink whenever they want one. They said people were given hot drinks at breakfast, 11:00, 15:00 at teatime and at 19:00 and in between they had cold drinks offered to them.

People were weighed regularly to enable the service to monitor people’s weight and take timely action if people lost or gained too much.

We observed people’s care records showed that they were assessed in accordance with the International Dysphagia Diet Standardisation Initiative (IDDSI) framework. No one at the service had modified food or drinks. Staff had a good understanding of people’s assessed needs in relation to type of food as well as any likes or dislikes. Staff told us they helped people to make their meal choices if they needed it. The menu for the week was on display in the kitchen in writing only. People did not have access to the kitchen, so needed to ask what the meals would be.

Food records showed people had a varied diet. People had access to snacks and drinks to meet their wants and wishes. Most people told us they enjoyed the food at the service. People told us they were not able to help with the cooking but did do some baking with staff on occasions. A person said, “[Staff member] is a very good cook, all the food is good.” Relatives told us, “I have never raised any concerns about food. She looks well fed” and “They have got a very good chef [staff name], she knows what he wants. A little bit at a time on his plate and he’ll eat it and if he wants more, they give it to him.”

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 provider had a clear process in place to escalate health concerns within a timely manner.

Staff worked with health professionals to ensure people got the care and support they needed. Community nurses visited the service twice daily to administer a person’s insulin. A staff member said, “Even the non-verbal residents can tell us if something is wrong, we can check their temperatures and book a GP appointment.”

The registered manager and staff told us, there were good links with other and the mental health team and social workers. Relatives told us staff accessed medical help when required. Comments included, “He sees the doctor when he needs to, and opticians and the dentist. He does not have much health needs. They tell me when he had flu and Covid jabs” and “She fell in May 2026, they got an ambulance and she went to hospital, anything like that they’re quick on that.”

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. We observed staff supporting people to maximise their independence, providing lots of praise and reassurances. We observed that plenty of fluids were offered to people to keep them hydrated and in good health.

People were supported to attend medical appointments if they were needed. People were also supported to attend regular dental check-ups and eye tests when they were needed. Staff had a good understanding of meeting people’s changing needs. Staff provided clear information about reporting concerns around low or high blood sugar levels to the surgery so that a nurse could attend. A person told us, “When I had a fall here, I went to the hospital.” A relative said, “They have a chiropodist go to the home. An optician goes to the home; she’s getting new glasses; she has been to the dentist.” Another relative told us, “I usually take responsibility for arranging GP appointments, so I can be sure that gets done, although I am sure they would do it if required. There is also a chiropodist who comes to the home, although I usually deal with that myself.”

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.

Staff worked together as a team to support people and to ensure people received their care and support in the way they chose. People were referred on to health care professionals when this was required, in a timely manner. A relative said, “They recognise her needs and if she is unwell.”

Staff completed handover meetings between shifts to pass on important information including any changes to health. Staff had communication books and communication messaging groups to enable effective communication and consistency.

The provider did not tell people about their rights around consent. However, staff respected people’s consent when delivering care and treatment.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The service did not always work within the principles of the MCA. Some people told us they made their own choices and decisions. Some people had full capacity to make specific decisions, and some people lacked capacity regarding specific decisions. Mental capacity assessments were not decision specific, they were vague and had lots of subjects rolled into one record, without detailing specific assessments and findings for specific decisions. There was no record of who had been involved in best interest decision making. Therefore, the principles of the MCA were not always followed.

Relatives told us they had observed staff offering their loved ones’ choices. Some relatives felt that choice was not always possible. A relative said, “No choice that way. If they have not got staff, he stays there and does not go out.” Another relative gave an example of when their loved one reported to them that they had been woken up early in the morning which was not their choice. The relative explained this was discussed with the management team, and this had not happened again.

However, we observed people making everyday choices and decisions about their lives during our visit such as what they wanted to eat, drink, what activities they wanted to do. Staff had a good understanding of consent. A staff member said, “I ask residents to pick their clothes of choice and I respect their choices. I will take 2 tops and 2 trousers, and [person] can pick. I always respect choices they have made.”