Sutton 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 good, and people’s feedback confirmed this.

This service scored 63 (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.

Staff considered people’s physical, mental health, social and communication needs, but information in care plans was not always correct, complete or contemporaneous. For example, changes to the frequency or level of support people needed was not always included or accurately reflected in care plans.

The provider ensured people and their relatives were involved in assessments of people’s needs and monthly reviews. A relative told us, “I come a lot so was here (for the resident of the day meeting), they involved [person] in what they wanted to eat etc.” Recognised clinical assessment tools were used to help inform care plans, and regularly updated.

Following feedback, the registered manager ensured care plans were reviewed for those identified.

The provider did plan and deliver people’s care and treatment with them, including what was important and mattered to them, but did not always ensure this was done in line with legislation and evidence based good practice.

Staff did not always ensure people had enough to eat and drink. People’s care plans did not always include accurate information relating to recommended fluid levels, and records evidenced people were not consistently offered fluids in line with good practice guidance. For people at risk of malnutrition, records showed food and fluids were not always fortified as advised in their care plans. When people were found to be asleep at mealtimes, staff had not always reapproached in a timely manner to ensure they did not go too long between meals or drinks.

The provider had implemented protected mealtimes so people could be supported to eat in line with their needs and preferences, and kitchen staff had a good understanding of people’s dietary needs and risks. We observed a variety of food on offer and received positive feedback about the standard of meals at the home. A person living at the home said, “I always look forward to lunch, it’s jolly good food.”

The provider’s policies were reviewed periodically to reflect current legislation and good practice; and staff attended webinars, meetings and forums to keep themselves updated with changes.

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 ensured information about people’s care was effectively shared amongst the team. Information about people’s needs was shared in daily handover meetings, and alerts on the electronic care planning system updated staff to any changes to people’s care and treatment.

Managers and staff were proactive in working with other services when multidisciplinary involvement was needed. Guidance from healthcare partners, including information about delegated clinical tasks, was shared with staff and included in people’s care records. A staff member said, “Emails (from the district nurses) are received and shared with the team in handovers.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff identified risks to people’s health and wellbeing, but the necessary reviews were not always carried out in line with guidance. The home used ‘National Early Warning Scores’ (NEWS) to record clinical observations if people became unwell. Dependent on the score, staff were advised to conduct further observations within a set timeframe and if there had been no changes to a person’s presentation, to seek an urgent medical attention. Repeat observations were frequently delayed or missed entirely, leaving people at risk of clinical deterioration.

The required level of support with oral hygiene was not always specified in people’s care plans, and some care records showed poor levels of support. Where people had declined support, records indicated staff had not always reapproached later, and there was no evidence repeat refusals had been escalated to a manager or prompted a review.

More generally, staff made referrals to healthcare partners, and weekly GP ward rounds ensured emerging or ongoing health conditions could be monitored. A person living at the home told us, “[Staff] are good at the medical side of things. If I need to see anyone about anything, they’ll make sure it’s arranged.”

Staff confirmed people were encouraged to make healthier choices with regards to their diet and physical activity, and chair exercise sessions were included on the weekly activities timetable.

Following feedback, we were assured the level of detail in people’s oral hygiene care plans would be reviewed.

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 provider had systems in place to monitor the effectiveness of people’s care, treatment and support. Concerns about people’s healthcare outcomes were monitored and discussed in monthly clinical governance meetings. Managers reviewed themes, trends and actions for issues such as weight loss, falls and distressed behaviours; and some positive outcomes were noted.

Staff ensured care plans were outcome focused and regularly reviewed.

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

Staff ensured assessments and decisions around consent were appropriately recorded, and relatives or advocates were involved when people did not have the capacity to make their own decisions.

People’s do not attempt resuscitation (DNAR) wishes were clearly recorded and included information about who had been involved in the decision-making process.

People’s level of capacity was detailed in their care plans, and staff understood the importance of making sure they obtained consent before they delivered care, support or treatment. One person said, “[Staff] always ask me first. I’ve never had anything done to me unless I’ve agreed.”