Grange Court Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.
 

This service scored 89 (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 was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.
Care plans were highly personalised and contained clear, detailed information to guide staff in delivering safe and effective care in line with people’s individual needs, preferences and expectations. Care records demonstrated people were actively involved in decisions about their care, with their views, life histories and personal goals clearly documented, regularly reviewed and consistently respected in practice.
We observed people receiving highly person-centred care that was responsive to their individual needs and preferences. Activities and daily support were thoughtfully tailored to reflect people’s interests, hobbies and life experiences, providing meaningful opportunities for engagement, choice and independence. This ensured care was not only structured around people’s needs, but also around what mattered most to them. For example, enabling a resident to keep in regular contact with a long-standing pen pal in America through letters, photographs and video calls.
Staff told us, “We have 2 very hard-working activity co-ordinators who do a great job. Everyone is busy with something interesting to them, going out to the café, visiting the canal, gardening, having nails done, signing etc.”
Where people could not clearly communicate their preferences, staff used well-developed care plans alongside their detailed knowledge of the person, and input from their next of kin, to ensure care remained aligned with their wishes. One person told us, “When [relative] comes to visit from abroad, we all sit down and talk about the care plans together.” This demonstrated a strong commitment to maintaining person-centred care for all people, regardless of their communication needs.
Staff demonstrated an in-depth understanding of people as individuals and worked flexibly to adapt care, routines in response to people’s changing needs and preferences. For example, where people became anxious during personal care, staff adjusted the timing and approach, such as providing care later in the day or involving familiar staff, which helped reduce distress.
Overall, the provider had created a culture where person-centred care was fully embedded and consistently delivered. People were supported to live in a way that reflected their individuality, preferences and life history, which enhanced their wellbeing, promoted independence and ensured care was meaningful and responsive at all times.
 

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.
There was strong evidence of effective partnership working with a wide range of health and social care professionals to ensure people received coordinated and responsive care. Professional visit records demonstrated regular and ongoing involvement from services including Parkinson’s nurses, nurse practitioners, GPs, speech and language therapists and occupational therapists,
External partners spoke positively about the service and told us staff worked collaboratively with them to achieve the best possible outcomes for people. They described the service as proactive in seeking advice and support from appropriate professionals in a timely way, ensuring people’s needs were met effectively. Examples of this practice were with the use of high-risk medicines reviews done 3 monthly with the nurse. Staff supported people closely and worked with the nurse on alternative techniques which resulted in 3 people’s behaviours being managed effectively and having their needs met needs to enable them to be taken off these medicines, which improved their health and wellbeing.
People and their relatives told us the service worked in a joined-up way, and care was delivered by a consistent staff team. This continuity supported positive relationships and ensured people’s needs and preferences were well understood. Care records clearly reflected the involvement of external professionals, with advice and guidance accurately documented and followed in practice.
The provider also demonstrated a commitment to supporting continuity of care. For example, they supported relatives to access appropriate funding to meet people’s needs and offered opportunities for people to transition to a sister service should their needs change, such as requiring nursing care. This helped to ensure people experienced a seamless and coordinated approach to their care as their needs evolved.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
The provider had systems and processes in place to ensure information could be made accessible to people in formats that met their individual needs. This included the ability to provide care plans and policies in alternative formats where required. At the time of the assessment, no one had requested access to their care records or asked for these in a different format.
The service environment also supported people to access information independently. Dementia-friendly signage was in place throughout the service to aid orientation and help people navigate their surroundings safely and confidently.
We saw that adjustments could be made promptly when needed. For example, large print information was provided to the inspection team. This demonstrated the service’s ability to respond flexibly to individual needs and ensure information was accessible.
 

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.
People were given regular opportunities to share their views and be involved in the development of the service. This included resident meetings, relative meetings and staff meetings, which were held consistently to gather direct feedback and encourage open discussion. The provider also used surveys to gather feedback from people, relatives and staff. These were analysed and the outcomes were shared, demonstrating a structured approach to listening and engagement.
We saw examples where feedback had led to positive action, particularly where improvements were identified in relation to the quality of care or individual expectations. For example, 1 person shared their interest in attending theatre concerts at, something they had previously enjoyed but felt was no longer possible. The service responded proactively and providing information on upcoming concerts, demonstrating a commitment to listening to people and acting on what mattered most to them.

People and relatives told us they felt included in decisions about care and were able to contribute their views and suggest improvements. They described feeling listened to and valued, with their feedback taken seriously. One person said, “Yes, I know the managers… I can go and talk to them,” and another said, “Oh I speak with [Nominated Individual] or [Registered Manager] anytime,” which showed people felt able to share feedback openly.
The provider’s records demonstrated people’s voices were heard and acted upon to improve their experience of care.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.
The provider had considered accessibility and inclusion when planning the care delivery. The premises were accessible and designed to promote people’s independence. People’s individual needs, including those related to dementia, were considered prior to admission. This included assessing people’s ability to mobilise safely and identifying how their independence could be maximised while managing risks. For example, the layout of the home and availability of adaptations, such as the staircase and lift, handrails and accessible bedrooms all supported people to retain independence in a way that was safe and appropriate to their needs.
People were able to access care and support 24 hours a day. Staff were available to respond to people’s needs at all times, including during emergencies. Professionals and relatives told us they were able to contact the service whenever required, and we saw that clear emergency protocols were in place, including out-of-hours contact arrangements for staff.
Care plans reflected people’s individual needs and identified any reasonable adjustments required to ensure equitable access to care and support. This demonstrated a commitment to providing inclusive care that enabled all people to access the service in a way that met their needs.
 

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.
For example, we saw evidence of trips out to local attractions, places of interest and also evidence of celebrations in service to commemorate important milestones for people, such as anniversaries and birthdays. This supported people to engage in meaningful activities that reflected their identity and promoted a sense of purpose, wellbeing and belonging.
People with protected characteristics received the same high quality of care, choice and opportunities as others using the service. Care was delivered in a way that was fair, inclusive and respectful, and there was no evidence of discrimination in how care, support or opportunities were offered. This ensured people experienced equitable outcomes and felt valued as individuals.
We observed people living with dementia experienced the same level of choice, inclusion and freedom as others. They were supported to take part in activities and outings alongside others, including visits to dementia cafés and local exhibitions. People were able to move freely within the service and access outdoor spaces such as the garden, with appropriate staff presence to ensure their safety. There were no unnecessary restrictions placed on people, and care was delivered in a way that balanced safety with maintaining independence, choice and liberty.
Activities were inclusive and highly person-centred, with clear evidence they were tailored to people’s individual interests, hobbies and life histories, including past working experiences. For example, we saw evidence of trips out to local attractions, places of interest and celebrations in service to commemorate important milestones for people, such as anniversaries and birthdays. This supported people to engage in meaningful activities that reflected their identity and promoted a sense of purpose, wellbeing and belonging.
For people who were unable to clearly communicate their views or preferences, robust and detailed care plans were in place. These captured people’s previously expressed needs, wishes and preferences across all areas of their care and daily lives. This enabled staff to deliver consistent, personalised care and ensured that people’s voices continued to be represented, supporting equitable experiences and outcomes for all.
The provider also demonstrated a thoughtful and person-centred approach prior to admission. Time was taken to get to know people, understand their individual circumstances and assess their needs comprehensively. This ensured decisions about admission were appropriate and based on people’s ability to achieve positive outcomes within the service, supporting a smooth transition and positive experiences from the outset.
Overall, the provider ensured that care and support was inclusive, personalised and equitable, enabling people to achieve positive experiences and outcomes regardless of their individual needs or protected characteristics.
 

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.
The provider ensured people were supported to plan for their future care through the use of personalised and comprehensive advance care plans. These clearly reflected people’s individual needs, wishes and preferences, and ensured people’s voices were central to decisions about their future care and treatment.
Care plans included clear reference to people’s stage of life, with Gold Standards Framework (GSF) coding used effectively. This provided staff with clear, up-to-date guidance on people’s needs and the level of support required, enabling a proactive and coordinated approach to care as people’s conditions changed.
Decisions relating to future care, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders and Respect forms, were appropriately completed with clinical oversight. These involved input from a nurse practitioner and ensured decisions were clearly documented, clinically informed and, where possible, aligned with people’s wishes and preferences.
The provider had maintained accreditation in the Gold Standards Framework for a number of years, demonstrating a sustained commitment to delivering high-quality end of life care. This reflected a well-established and embedded approach to planning ahead, ensuring people received compassionate, coordinated and responsive care at the end of their lives.
Staff were appropriately trained and supported to deliver end of life care and spoke confidently about their roles. This ensured people were supported with sensitivity, dignity and reassurance as their needs changed, contributing to positive experiences and outcomes at this important stage of life.
Feedback from relatives further reflected the positive impact of this approach. One relative told us they were “Very thankful for making the end of [person’s] life so comfortable and enjoyable,” highlighting the compassionate and person-centred support provided at the end of people’s lives.