Heywoods 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 changed to requires 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, and the application of the Mental Capacity Act.
 

This service scored 42 (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 make sure people’s care, and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. Staff and relatives described a good understanding of people's day-to-day needs, preferences and routines. We found examples where specialist referrals had not been actively followed up when appointments were delayed, and there was no structured early-warning monitoring tool in place for a person with complex mental health needs. One relative told us, "They know [relative] really well," while another said staff were "incredibly sensitive to [relative's] mood swings." However, behavioural incidents were not consistently recorded, monitored or analysed, with daily records often containing only brief narrative entries. These shortcomings limited the provider's ability to demonstrate effective oversight of people's changing needs and ensure timely intervention when risks to health and wellbeing increased.

The provider did not always plan and deliver people’s care and treatment with them. They did not always follow legislation and current evidence-based good practice and standards. The provider had reviewed care plans in January 2026, and these contained personalised information and incorporated people's views, wishes and preferred routines. Relatives also described staff as knowing people well and understanding their individual needs. However, records did not consistently demonstrate that care was delivered in line with care planning guidance. We found examples where health recommendations, behavioural monitoring, specialist advice and agreed support arrangements were not consistently implemented, reviewed or evaluated. This limited the provider's ability to demonstrate that people consistently received care and treatment that reflected their assessed needs and planned outcomes.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. We reviewed positive feedback from external professionals, including a Consultant Neuropsychiatrist who described the placement as having "materially and substantially improved" one person's quality of life. This demonstrated that staff could work successfully with specialist services to achieve positive outcomes. However, this approach was not consistently reflected across the service. Records showed specialist referrals, clinical recommendations and healthcare interventions were not always followed up, reviewed or embedded into care planning in a timely manner. As a result, the provider could not consistently demonstrate effective multi-disciplinary working or coordinated oversight of people's care and treatment.

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. The provider supported people to access activities and opportunities which promoted their health and wellbeing. Relatives described positive outcomes for people through activities, community involvement and support with emotional wellbeing. One person enjoyed regular swimming sessions, described in their care plan as their "favourite part of Tuesday", while another relative told us staff had worked hard to help their family member rebuild confidence and manage anxiety following the COVID-19 pandemic. Staff also supported people to access holidays, community activities and meaningful interests. However, records did not consistently demonstrate how healthier lifestyle goals, physical activity, emotional wellbeing and independence were planned, monitored or reviewed. Opportunities remained to further embed health promotion and community engagement into people's everyday support.
 

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. The provider had systems in place to monitor aspects of people's health and wellbeing, including body maps, bowel charts and daily care records. Relatives generally told us people experienced positive outcomes and staff understood their needs well. However, information gathered through monitoring systems was not always analysed or used to evaluate the effectiveness of care. Daily fluid records were not routinely checked against personalised targets, behavioural incidents were not consistently reviewed for patterns or triggers, and outcome trends were not monitored at service level. As a result, the provider could not always demonstrate that monitoring information was being used to drive improvement and support better outcomes for people.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider did not consistently apply the principles of the Mental Capacity Act 2005 or demonstrate how people's rights were protected when decisions were made on their behalf. We found no documented mental capacity assessments for a range of significant decisions affecting people's daily lives, despite some people requiring support to make decisions about medicines, finances, restrictions and aspects of their care. Relatives gave mixed responses regarding MCA and DoLS arrangements, with several unaware whether assessments or authorisations were in place. The Deputy Manager acknowledged that MCA and DoLS processes had only recently been commenced. The provider was also unable to produce consent records relating to photographs and videos published on social media.