Christopher Grange Rhona House

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 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 assessment for this newly registered 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 67 (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’s needs were assessed when moving to the service. Care plans were put in place to guide staff on how to support people safely. One family member described the moving in process. They said, “We were anxious about [Name] moving into the home due to now needing nursing care but the nurse on charge when we arrived was very comprehensive. [Name] was weighed, had their skin checked, talked about likes and dislikes, given a menu and we discussed the level of food [Name] requires. Assessments were done and everything was put in place. Very good first impressions. [Name] told me they were checked on every 2 hours and I felt reassured.” Another family member confirmed they were able to choose the bedroom for their loved one and had been involved in the development of the person’s care plan.

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. For example, the staff team worked closely with the community physiotherapy team to look at ways to support one person to mobilise safely whilst maximising their independence. We observed people were assisted safely when eating and drinking and staff delivered care which was in line with professional advice. During mealtimes, people’s preferences were met and we observed staff were attentive. This meant people experienced a positive mealtime where they did not feel rushed. Overall, we received positive feedback about the food available although some people told us the presentation and temperature of food could be improved. We shared this feedback with the management team.

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 worked with other professionals to ensure good health outcomes were achieved. Visiting professionals spoke positively about these relationships. They told us staff were aware of people’s needs and took appropriate action to escalate health concerns when needed. One commented, “They are caring and listen to our instructions. In Rhona House the leadership is quite strong.”

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 and reduced their future needs for care and support. Some people chose not to follow medical advice to encourage healthy living. People’s decisions in this area were respected. One person did tell us they would like more fresh vegetables to be offered with their meals. We shared this feedback with the provider.

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 they met both clinical expectations and the expectations of people themselves. Records were not always accurately recorded. For example, some food and fluid input and output records were incorrect or incomplete which did not always give an accurate picture of the amount of food and fluid a person consumed. One person needed assistance to regularly reposition in bed. Some records did not always capture this assistance had been provided in line with their care plan. Staff did not always record when a person had been offered but then refused an aspect of the care. This meant records indicated some care had not been offered to a person which was factually incorrect. Daily handovers were completed where staff discussed individuals and any changing need. Systems to ensure sufficient oversight of people’s clinical care needs had recently been implemented.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Records did not demonstrate assessments about people’s capacity and decisions made in their best interest were always made in line with the Mental Capacity Act 2005. This was because they were not always decision specific. For example, one person had records around their ability to consent to their overall care however, lacked a record for a specific restriction such as having bed rails. Staff told us, and we observed staff seek people's consent before undertaking care tasks.