Melwood 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.

This is the first inspection for this service. This key question has been rated 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.

Before moving into the home, some people had transitioned from a smaller care facility and had undergone a needs assessment. Documentation indicated that residents’ opinions and preferences were respected, heard, and incorporated into daily care. Care plans, created based on these initial evaluations, helped staff provide support tailored to each person’s unique requirements and wishes.

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.

Staff were knowledgeable about best practices and supported people with diverse needs, having completed various relevant trainings. While care plans included allergies and health details, and staff documented changes in needs following professional advice, opinions on food quality varied. Many felt improvements were urgent, citing concerns over ingredients and nutrition, though some found the food good. Comments included, “Food can be difficult because what they give us, it’s not really beneficiary to health-not real good meat or vegetable and “We would really like better food; the ingredients are not of good qualities. Like sausages, today instead of chicken we have turkey stew, I never heard of turkey stew.” The registered manager told us they would ensure all staff knew the correct menu choices.

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. Staff told us they felt there was good teamwork. Nurses and senior care workers had a good working relationship with the local GP surgery, in particular the health care professional who visited the service regularly.

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. Staff were knowledgeable about specific health conditions such as diabetes or epilepsy. People were supported to see doctor’s or other health professionals when they needed to. People’s oral needs were assessed and people told us they were supported to see the GP.

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. Staff at the home closely monitored people’s clinical outcomes. People, their relatives where appropriate and professionals were involved in their care. Changes in care needs were raised with relevant healthcare professionals, with outcomes monitored and followed up. Staff had a clear knowledge of expected progress of treatments and escalated appropriately when people’s health was declining. Changes and progress were monitored and shared and reviewed by the visiting GP.

The Mental Capacity Act 2005 (MCA) establishes the legal framework for decision-making on behalf of people who may lack the capacity to make specific decisions themselves. The MCA requires that, wherever possible, individuals are supported to make their own decisions. When a person is assessed as lacking capacity for a particular decision, any decision made on their behalf must be in their best interests and represent the least restrictive option available. Where individuals were assessed as lacking capacity, mental capacity assessments had been completed.

As documented in medicines we did not see evidence of best interests being completed for 1 person. We brought this to the attention of the registered manager who told us they would address this.

Staff had completed training on the MCA and demonstrated a clear understanding of its principles. Where people required assistance with decision-making, staff were able to tell us how they applied best-interest decision processes and ensured that any actions taken were the least restrictive option and we saw evidence of best interest decisions recorded in people’s care plans. One staff member told us, “If someone does not have the capacity to consent, we consult their family members or carers to see if they are in agreement that decisions relating to the supported person’s care are made in their best interests.”