Upton Grange Residential Home

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• 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 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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider used nationally recognised assessment tools to monitor and support people's skin integrity and nutritional needs. We reviewed comprehensive pre‑admission assessments, which ensured staff had a good understanding of each person’s needs before they moved into the service. Staff told us they knew the needs of people via handovers and care plans. Relatives confirmed this, with one telling us staff were fully aware of their family member’s communication needs prior to admission. They said, "Not one person does not know about their communication needs; we have not had to tell any staff."
 

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 provider made timely and appropriate referrals to relevant health professionals, and care plans were routinely updated to reflect new information. Clinical assessment tools, including the Malnutrition Universal Screening Tool (MUST) and the Waterlow scale, were used effectively to identify people’s needs, and preventative measures were followed. Care plans included clear information about people’s dietary requirements, and staff demonstrated a good understanding of these needs in practice.

Feedback from external health professionals was positive. One professional told us, “We have seen things put in place and have seen an improvement in (name) over the last 10 days.” Care plans were updated after our feedback.

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.

Guidance from partner agencies was clearly documented within people’s care plans. We reviewed updated plans which reflected outcomes from recent GP visits and new instructions provided by district nurses. This information was promptly shared with staff, who consistently followed the updated guidance.

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.

Records were appropriately maintained to show when staff had made referrals to external agencies. People were supported to attend routine healthcare appointments, and we saw evidence of this in practice. For example, one person had recently been supported to attend their regular podiatry appointment. All staff had completed first aid training, and first aid kits were generally well stocked.

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.

People had access to regular clinical input, including daily visits from district nurses and routine GP reviews, supporting ongoing health monitoring. Staff monitored and recorded information about people's care needs and the care they provided. Staff told us they would raise or report any concerns should they need to. Feedback from health professionals supported this. One health professional told us, "Wound care is always escalated if staff are concerned and staff follow instructions. We addressed what support staff needed and they have responded positively, staff have listened to our advice."

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Some mental capacity assessments required further details regarding how capacity had been assessed in line with the principles of the Mental Capacity Act 2005 (MCA).

Some people were unable to consent to their care. Where required, appropriate applications to deprive the person of their liberty under the Deprivation of Liberty Safeguards (DoLS) had been made. A monitoring system had been implemented to ensure DoLS and mental capacity assessments were reviewed on a regular basis.

Staff consistently sought consent from people before delivering care or support, and we observed this practice in action several times during this assessment. A staff member told us, "We always ask." Staff respected people’s decisions and preferences, recognising when to return at a more appropriate time.