Grande Care Ltd

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 remained 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.

A comprehensive assessment of people's needs was carried out before they started to receive care and support from the service. People’s past history was considered in their care planning, together with their likes, dislikes and preferences. This meant the registered manager could be assured the service could effectively meet people’s needs. One relative told us, “When we first used Grande Care the manager came and completed a very comprehensive care plan. Risk assessments were completed and procedures discussed as to what to do during a crisis.” Another relative commented, “When the manager came to assess I was very impressed as she sat with me and [Name] discussing health conditions and behaviours, completing a very comprehensive risk assessment and overview of care requirements.”

People’s care plans were regularly discussed with them so they could be updated to reflect any changes in the support people needed or how they wished their care to be provided. In a recent review 1 relative commented, “Care plans and protocols have been amended and updated as required and there continues to be excellent liaison with the medical professionals involved in [Name’s] care.”

Staff told us they informed the registered manager of any changes in people’s needs so their care plans could be reviewed and updated.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, there was inconsistency in recording to demonstrate this was always in line with current evidence-based good practice and standards.

Staff supported people to eat and drink to remain healthy. One person told us, “They are very good at keeping me healthy as they provide a high protein diet and plenty to drink.” A relative commented, “They will provide the food [Name] enjoys and ensure they are kept well hydrated.”

However, information within people’s care records was not always accurately recorded. For example, 1 person’s care plan had not been updated to reflect they no longer required thickener to be added to their drinks. Despite these inconsistencies, staff understood people’s nutritional needs. Comments included, “I ensure meals meet their requirements, monitor intake, and report concerns immediately” and “We always follow dietary instructions such as if our client has hypertension, we will offer low sodium or sodium restricted diet.”

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.

The registered manager made referrals to, and worked with, other external health and social care teams such as peoples’ social worker, GP, epilepsy nurse and occupational therapist. This helped monitor people's well-being and helped to ensure a continuity of care.

People and their relatives spoke of good communication between the staff team and other health and social care professionals. Comments included: “Their detailed knowledge and coordinating with specialist clinicians has produced a gold star care plan” and “The carers also interact well with each other when handing over and work well together as a team.”

Staff described good communication and teamwork to ensure people received the support they needed, when they needed it. One staff member told us, “Communication and coordination within the team is good. We use handovers, staff meetings, and written logs to stay updated. This helps us provide consistent care, especially for new staff or those back from annual leave.” Another staff member explained, “Without communication we can’t do anything. We need a good personal relationship within the team."

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 encouraged people to maintain their hobbies and interests to support their physical, mental and social wellbeing. One relative told us, “The carers take [Name] to events within the community, such as yoga, walking and bowling. They look after [Name] holistically and ensure not only their mental health needs are met but also their physical needs.”

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.

Changes in people’s presentation, emotional state or distress which may show a deterioration in their health or wellbeing were recognised by staff. Staff acted when they identified changes in people’s health and escalated them to relevant professionals. One staff member told us, “Training helps me spot changes. I escalate concerns to the manager and document observations promptly.” Another staff member commented, “I regularly observe clients for signs of health changes, like pain, confusion, skin changes, or discomfort. If I notice anything like a UTI or pressure ulcers, I report it immediately and follow the care plan.”

Relatives spoke of positive outcomes for people due to effective monitoring of people’s health and wellbeing. One relative told us, “Accurate records are kept of all activity that has occurred, mood changes and what interventions have taken place.” Another relative said, “There are activity records in [Name’s] home that provide a story of what they have done regarding activities, what they have had to eat and drink and also complex medication charts that are completed with no errors.”

We discussed with the registered manager the benefit of completing monitoring charts for the effectiveness of ‘as required’ medicines, even when people had capacity to recognise when they needed them. The registered manager assured us they would introduce monitoring charts for these medicines.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were encouraged and supported to make their own decisions about their care needs and daily lives. One person told us, “The staff are well trained, and they always ask me if I agree to be washed and what I would like to eat and drink. I am very involved with how I want my care to be provided.”

Care plans prompted staff to seek people’s consent prior to any care intervention and staff told us they would respect people’s right to decline the support being offered. Where people with capacity made decisions with risk, this was respected. When people needed assistance with making complex decisions, they had somebody who could support them to make those decisions in their best interests.

The registered manager understood the process if they had concerns people did not have capacity to make decisions about their care.