Grange Court Residential Home

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 outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.
 

This service scored 92 (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, wishes and preferences were identified before admission through a detailed assessment process. This included their health, wellbeing, personal care and social needs. This information was used to develop care plans, helping to ensure care was person centred from the start.
Care records reflected people’s preferences, including access to services such as chiropody, opticians and hairdressing. This helped people maintain routines and lifestyles that were important to them.
Where people’s needs changed, care records were updated to reflect their current support needs. This showed the provider responded to changes and kept information accurate to guide staff.
Relatives gave positive feedback about this process. One relative said, “[Name of relative] came in here very quickly, I have spoken to [Nominated Individual] a lot already, they are absolutely brilliant. They have responded very well to [relative] and know them so much already.”
 

The provider always 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. They worked to develop evidence-based good practice and standards.
The provider demonstrated a strong commitment to delivering care and treatment in line with current evidence and best practice. Care records contained clear and detailed input from a range of health and social care professionals, and staff used this information effectively to inform and adapt people’s care.
The provider worked proactively in partnership with external specialists, including the Support and Train to Eat Well (STEW) nutritionist, to support people identified at risk of malnutrition. Targeted training had been provided to both care and catering staff to enhance their knowledge and understanding of nutrition. This was supported by the implementation of evidence-based food fortification strategies, tailored to individual needs.
These approaches led to measurable and sustained improvements in people’s outcomes. Several people experienced improved nutritional intake and weight gain, and in some cases, were able to be safely reduce prescribed nutritional supplements. This demonstrated how evidence-based interventions were used effectively to achieve positive and person-centred outcomes.
People spoke positively about the food. They said meals were good quality and tasty, and they were always given choice, showing their preferences were respected.
 

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.
The provider demonstrated highly effective partnership working, ensuring seamless communication and information sharing between staff teams and external professionals. This collaborative approach ensured that people experienced well-coordinated, timely and person-centred care that met their needs.

Feedback from health and social care professionals was consistently positive, reflecting a strong culture of collaboration. Professionals described staff as committed to joint working and spoke positively about the implementation of the STEW model. This partnership working enabled staff to effectively manage people’s expectations in relation to clinical care and contributed to improved health outcomes, including better nutrition and reduced clinical risk.

Professionals confirmed they were provided with clear, relevant and timely information when accessing the service. This included comprehensive care records, risk assessments and up-to-date clinical information, enabling them to deliver care and treatment safely and efficiently. As a result, decision making was timely and well-informed, reducing delays and ensuring that people received the right care at the right time.

Communication within staff teams was observed to be effective and well embedded in practice. Information about people’s care and support needs was shared through structured handovers and day-to-day interactions. This ensured continuity of care, minimised risk of errors or omissions, and promoted a consistent approach to meeting people’s needs.

People and their relatives spoke positively about the way staff worked together to support their health and wellbeing. They described feeling involved in their care and part of a supportive environment. One relative told us, “It’s like family, everybody is being looked after.” Others commented on the strong teamwork within the service, saying, “They all work well together, they have very good teamwork.”

Staff consistently described clear roles and effective coordination when working alongside external professionals. One member of staff told us, “If the district nurses or GP come in, 1senior supports the visit while others continue leading the shift.” This organised and responsive approach ensured that external input was fully utilised without disrupting the care of others, supporting safe, efficient and well-coordinated service delivery.
 

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.
People were supported to live healthier lives through a range of personalised and proactive approaches. They were provided with a variety of nutritious food, drinks and snacks throughout the day, which reflected individual preferences and dietary needs and supported positive health outcomes.
A wide and meaningful range of activities was provided to support people to remain active, independent and socially connected. This extended beyond the service, with people regularly supported to access the local community and maintain relationships that were important to them. Opportunities included attending community groups, such as dementia cafés, sponsored by the provider, as well as outings and social activities tailored to people’s individual interests and life histories. This approach promoted physical wellbeing alongside emotional wellbeing, social inclusion and a sense of belonging.
The provider demonstrated a strong commitment to enabling people to maintain and develop important relationships. This included supporting people who were related or in long-term relationships to live together within the service, including married couples. Partners and family members were welcomed and supported to spend extended periods of time within the service, and arrangements were flexible to accommodate this where appropriate. This ensured people could sustain meaningful relationships and reduced the risk of social isolation.
People were supported to access routine and specialist healthcare services, including health checks, dentists and opticians. Records demonstrated people received appropriate and ongoing support for their health conditions, ensuring continuity of care.
Staff demonstrated a strong understanding of people’s health needs and were able to recognise and respond to early signs of deterioration, such as urinary tract infections and pressure ulcers. This supported timely intervention and helped prevent avoidable decline in people’s health.
 

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.
The provider used nationally recognised, evidence-based clinical monitoring tools to support care and treatment in line with current best practice. These were in place at the time of the assessment and included tools to monitor areas such as nutrition, falls, skin integrity and end of life care, including the Gold Standards Framework (GSF). The Gold Standards Framework is a structured approach to improving end-of-life care through better planning and coordination.
These tools were used effectively to identify early signs of deterioration. For example, people at risk of weight loss had food intake charts in place, those approaching end of life were supported through the GSF pathway, and those at risk of falls had appropriate risk assessments completed.
Staff regularly recorded and reviewed people’s conditions, which supported timely clinical decision-making and ensured appropriate escalation when required. This enabled early intervention, reduced the risk of avoidable deterioration, and improved outcomes for people.
As a result, we saw positive outcomes for people using the service. For example, people who had previously experienced falls saw a reduction in incidents after reviews and the introduction of effective mitigation measures.
People and their relatives told us they felt supported to achieve the best possible outcomes. Relatives described significant improvements in people’s wellbeing and safety. One relative told us, “It helps me sleep at night… the last 3 years have been so stressful, [name of relative] had 11 falls. I am so glad [name of relative] is here, I know they are safe.”
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
People were supported to have their needs, wishes, preferences and rights upheld within the service. People and their relatives told us they were involved in contributing to care records and in decisions about their care and support.
We observed staff consistently gaining consent before delivering care. People, relatives and other health professionals were involved in decisions relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders. The nurse practitioner told us they were actively working to further improve and strengthen this process when people were admitted to the service.
Where people lacked the capacity to make decisions about their care, appropriate mental capacity assessments had been completed, and best interest decisions were in place. These involved relevant people, including next of kin or advocates, to ensure decisions were made in accordance with legislation and in the person’s best interests.