Henwick 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 Inspection we rated this key question good. At this Inspection 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.

This service scored 58 (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 always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care and wellbeing needs with them. People and relatives told us they were not involved in care planning and reviews, and we could see no evidence of this in peoples care documents. However, care plans were detailed, and regular reviews of people’s needs were taking place. Daily meetings were held to share people’s changes in care delivery or any concerns in their health and wellbeing. The service held a resident of the day process, however, this was a missed opportunity to ensure people and relatives were involved in their care planning. After sharing our feedback, the registered manager had started to take action to ensure people and relatives became more involved in their care reviews.

The provider did not always plan and deliver people’s care and treatment with them, and this was consistent with the feedback we received. Risk assessments were in place to help identify risk factors specific to each person, such as manual handling, falls and specific nutrition needs. This helped to provide staff with information on how to manage and minimise these risks and provide people's care safely. Care plans held good information about modified diets and people’s specific dietary requirements. Staff, including kitchen staff shared good knowledge of people’s dietary requirements and there was guidance and pictorial aids located in the kitchen. However, further improvement with documentation was needed to ensure there was accurate recordings of how much people had eaten and drunk. We shared our findings with the registered manager who took action to amend some of the documentation.

The provider worked well across teams and services to support people. People were supported by staff who worked in conjunction with other healthcare professionals. We received limited feedback from professionals; however, we could see information about people’s needs had been shared and documented in people’s care files. An external professional told us the service communicates well with them and keeps them updated of any changes. Referrals had been made to the relevant health professionals. The service had daily handover sheets and flash meetings to share information about people’s needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives. Care plans showed people had access to external professionals when required, these included GP’s nurses, dietitians, continence services, chiropodists, physiotherapists, dentists and the mental health team. One person told us, “I have seen the doctor, they cover all my health needs. I have a referral to have eye surgery’. We saw where needed, people had regular reviews with specific health care consultants such as psychiatrists and cardiologists.

The provider monitored people’s care and treatment to continuously improve it. However, they did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. There were records to demonstrate people’s care was provided, but we found gaps in the documented recordings. For example, staff did not always record when people had food, fluids or had been repositioned. Some recordings had been duplicated which made it difficult to have a clear overview of what support had been given. We therefore cannot be assured people were receiving care and support as per their care plans. We shared our findings with the registered manager who told us they would review their processes to monitor people’s daily documentation.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We received mixed reviews from people and relatives regarding consent and observed both good and poor practice by staff. One person told us, “I don’t think they do know what my likes are, it’s just general care’. ‘I’m not restricted ever”. We observed some poor interactions during our inspection process where some people were not consulted when staff administered medicines or were not asked how they would like their care delivered. Equally, we saw positive interactions where some staff asked permission before carrying out care tasks and asked consent before entering their room. Our findings were shared with the registered manager, who arranged further training for staff. Staff shared a good understanding of the Mental Capacity Act and how to assess people’s consent to care and treatment, however they did not always put this into practice. People had reviews of their capacity to make decisions about their care and treatment. The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty (DOLS). There was evidence referrals had been made to the local authority. The provider monitored when people’s assessments and DoLs needed reviewing.