Mandeville Grange Nursing Home

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 inadequate. At this assessment the rating has changed to 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.

People were assessed prior to admission to ensure the service could meet their needs. The registered manager confirmed all assessments were carried out by them, face to face, and usually accompanied by another staff member such as the clinical lead to support their learning and development. The assessments we reviewed were comprehensive, well-completed and effectively documented people’s needs. Where there was a delay between assessment and admission people were reassessed to ensure their needs had not changed and the service could continue to meet them.

The service had developed robust systems to communicate information about new admissions to all relevant staff, including the chef. This ensured everyone was aware of people’s needs and potential risks before admission, promoting safe and co-ordinated care.

Staff confirmed this was the case. They were able to access pre-admission assessments on the care planning systems, which enabled them to have an understanding of the person’s needs with care plans and risk assessments developed and available on the persons admission to the service.

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 service delivered care and treatment in line with recognised best practice. They used validated tools and guidance to inform people’s care, including the Malnutrition Universal Screening Tool (MUST) to assess nutritional risk, Waterlow scoring to monitor skin integrity and structured approaches to managing distressed behaviours. Risk assessments were completed for falls, mobility, and long-term conditions, such as diabetes following recognised guidance to ensure interventions were safe and tailored to individual needs.

Staff told us how they were aware of people’s specific dietary needs and explained how they met those needs. Systems were in place to ensure the kitchen staff were aware of people’s dietary needs and associated risks including specialist diets, fortified diets, International Dysphagia Diet Standardisation Initiative (IDDSI) diets and supplements. Each person had an information sheet, kept in the kitchen outlining their dietary requirements and kitchen staff attended the daily morning meetings to ensure they were up to date with any changes, supporting safe, individualised, and evidence-based care.

The team meeting minutes showed discussion on nutrition analysis which identified people on specialist diets, those who had lost weight and actions taken.

People and relatives were happy with the meals provided. A person commented, I am offered meal choices, the menu is communicated in advance. Staff come and ask what I prefer to have from the menu earlier in the day before lunch time,” and “The food is always so good, staff always ask for my choice and the menu is shared in advance.”

A relative commented, “Absolutely. [family member] has good meals and they say it is ‘good food’. Staff make sure that they have juice on hand all day. They bring in biscuits and tea every morning and afternoon. [Family member] has three meals a day, and they say they are well fed.'

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 clear systems in place to ensure information was shared effectively among team members, supporting the consistent delivery of care to meet people’s needs. Staff were kept up to date on changes in people’s needs through handovers, morning meetings, updates to care plans and electronic prompts from the service's care planning system. The registered manager also used a communication book to share important messages promptly with staff. All staff were encouraged to attend team meetings and contribute to discussions, creating multiple opportunities for open and effective communication.

Staff reported that communication within the team was effective which enabled them to provide safe, consistent and person-centred care. A staff member commented, “Staff morale is better. We work better as a team now and communication is great.”

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.

The service worked closely with other health professionals with people having access to a weekly GP review. They used Telemeds which is a service available to care homes and provides virtual consultations with GPs and healthcare professionals via secure video and phone platforms to promote timely access to specialist advice and escalation to health professionals as required.

The service had weekly and monthly clinical governance meetings which enabled them to review changes in people’s health in a timely manner and escalate to the GP or other professionals if required. Choking risks and weight loss were a standing agenda item at the meetings to ensure continued review of these risks.

Relatives told us they were informed of changes in their family members health and that their family member had regular access to a GP. A relative commented, “It is a two-way liaison, and I am kept well informed.'

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.

The registered manager had effective systems in place to monitor and improve outcomes for people, including clinical needs. A risk matrix and regular reviews of incidents and accidents were used to identify changes in people’s health and well-being with appropriate actions taken including referrals to healthcare professionals where required. Care plans were regularly reviewed and updated to reflect changes in people’s needs and preferences ensuring care remained responsive, person centred and ensured people’s outcomes were consistently monitored and improved, supporting safe and effective care.

The service operated a keyworker system, where each person was supported by 2 designated staff to provide consistent oversight across all shifts. This ensured continuity of care and enabled staff to monitor people’s needs and outcomes effectively, with any changes identified and responded to promptly.

Since the previous inspection we saw evidence of improved outcomes for people. A person who had previously been distressed and anxious appeared settled and engaged positively with staff. Another person had become the resident ambassador for the service, contributing to decisions within the service reflecting improved well-being.

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

People’s consent to care was sought and respected. From our observations and records viewed we saw people were supported to make decisions about their care and treatment where they had capacity. Where people lacked capacity, assessments and best interest decisions were completed in line with legislation and involved those relevant to the person.

Policies and procedures guided staff, who had received training in consent and capacity, supporting them to provide care in line with people’s rights and choices.