Grenham Bay Court

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People’s needs had not always been comprehensively assessed. Some people had long term medical conditions which were noted in people’s care plans. However, it had not been assessed how these conditions affected people’s quality of life and how staff could support people. For example, some people had long term conditions which affected their breathing and at higher risk of chest infections, there was no guidance for staff about how to support people.

Staff had reviewed people’s care plans regularly; however, changes had not always been made when their needs had changed. For example, when people returned from hospital their care plans had not been updated with the treatment they had received and any side effects staff should be aware of.Relatives told us they had been involved in discussions when incidents happened and what strategies should be put in place to reduce the risk of them happening again. Staff knew people well and could support people daily.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. This was not always in line with legislation and current evidence-based good practice and standards. People’s needs were assessed using recognised tools including Waterlow scale to identify when people were at risk of skin damage. When people had required specialist equipment such as pressure relieving mattresses these were not always set at the appropriate level. For example, a person’s mattress was set at 80kgs, there was no information as to why, or if it had been reviewed as staff had been able to weigh the person for a year. There was a risk the mattress would not work effectively.

The risk of people losing weight had been assessed using the Malnutrition Universal Screening Tool (MUST) to provide guidance about the action staff should take. People had been referred to healthcare professionals such as the dietician; staff followed the guidance given including nutritional supplements. We observed people being supported to enjoy snacks and have nutritional supplements and drinks.

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. When people were transferred to hospital, staff could print the important information about people’s care needs. However, there was a risk that this information may not always be accurate as some people’s care plans had not been updated when they returned from hospital. There was a risk, when people were not accompanied by staff, healthcare professionals would not have the up-to-date information.

Staff held handovers between each shift, we observed a lunchtime handover, which included any changes in people’s needs or health that day. Relatives told us they were kept informed when people’s needs changed or people had fallen. A relative told us, “I can see her records and I know what’s happening “. Also, “There’s always someone keeping an eye out for her and when she’s had a fall they’ve rung me straightaway to let me know what’s happening.”

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 were supported to be as active as possible, supporting people to walk around the building.

Staff maintained contact with the GP surgery and there were regular visits to discuss people’s healthcare and make changes when needed. People were supported to access health professionals such as the optician or chiropodist.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. When people were living with health conditions such as diabetes, guidance was not clear about the expected outcomes for people such as the expected blood sugar levels. When people had long term health conditions, the provider had not discussed what people wanted to achieve or how to improve their quality of life. For example, some people had their blood pressure recorded regularly but there was no information in their care plan about why this was being completed and what the expected outcome was.

Some people’s diet and fluid intake were recorded to make sure they remained well. Staff monitored people’s charts and supported them to eat or drink more if required. A relative told us, “It’s always been a problem to get her to eat. She needs prompting and to begin with they would call us to ask for advice on getting her to eat. They still must prompt her, but they are getting her to eat.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood their role to promote people’s choice and respect their wishes. We observed staff asking people what they wanted to do, sit and eat. People told us, they spent time in their room when they felt like it and would come to the communal areas when they wanted company. Staff described how people’s choices were respected, we observed, staff supporting people to do what they wanted.

People’s capacity had been assessed, and this was documented. When people had been assessed as not having capacity, decisions had been made in their best interest with their family and healthcare professionals. A relative told us, they had been involved in deciding if their family member should have their medicines covertly. They were happy with the outcome as this had meant their family member was now more settled and accepting of support.