Graysford Hall

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 75 (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 had an initial assessment within 24 hours of moving into the service. This included the completion of a body map and risk assessments. Over the next 7 days, staff liaised with the person, relatives, and health and social care professionals to gather information. Care plans were developed, covering the person’s health, care, wellbeing, and communication needs. This process helped to ensure people received care and support that had the best possible outcomes for them.

Staff told us assessments helped them get to know new people and how best to communicate with them. A relative told us their family member’s assessment helped everyone involved decide which floor of the service would suit them. They said their family member was now settled at the service and liked the floor they were accommodated on.

The provider planned and delivered people’s care and support in line with legislation and current evidence-based good practice and standards.

The provider’s systems ensured staff were up to date with changes and developments in health and social care. At provider level, the nominated individual, specialist leads, and a quality management team, provided advice, support, information and updates to staff at their locations, including Graysford Hall.

Managers of the provider’s locations had their own support network. They met regularly to share ideas, good practice, and lessons learnt, and to give presentations on what was working well at the locations they managed.

Staff understood and used national tools including MUST (a malnutrition universal screening tool) and Waterlow (a risk assessment tool for managing pressure areas) to assess and monitor people’s needs. This helped to ensure risks to people’s health were identified and addressed.

Records and observations showed people received adequate food and drink, including fortified meals where necessary. Staff managed pressure areas effectively and ensured people were regularly repositioned to reduce risk.

The provider worked well across teams and services to support people. Managers and staff worked in partnership with external professionals to ensure care and support was holistic.

People received care and treatment from visiting health care professionals who collaborated with staff at the service to understand and meet people's health care needs. These included district nurses, GPs, speech and language therapists (SALT), dentists, opticians, and physiotherapists.

Two visiting health care professionals, who came to service regularly, said the staff were skilled at supporting people and managing their health care needs. They told us the staff were knowledgeable about people’s needs, and good at skin careand repositioning people. They also said the documentation kept was of a high standard which made information-sharing more effective.

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.

Relatives said staff knew how to identify risks to people’s health and well-being and acted to prevent deterioration. A relative told us, “Staff are very good about people seeing a GP. If there is anything they are worried about they put them on the ‘ward round’ and they are seen, so that is reassuring.” A visiting health care professional commented, “Staff don’t wait for health care professionals to come in, they let them know straight away if there are concerns.”

Managers and staff had a positive relationship their local GP surgery. For example, doctors provided weekly ward rounds at the service, and district nurses supported people with regular wound care, continence care, catheter care, and skin checks. By working closely with health care professionals and valuing their support and guidance, staff ensured people’s medical needs were met.

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.

People and relatives said people’s health and wellbeing had improved since they came to the service. A person told us they had seen others improving, including a person who had gone from being supported in bed, to using a chair, and joining in with activities in the lounges. A relative commented about a different person, ”They were very poorly when they came in, but they have come on in leaps and bounds and are so much better now.”

Records showed people experiencing positive outcomes at the service as their health and social care needs were met. Staff told us about a person who had frequent falls. Through investigation and observation, staff determined the cause of these. They then worked with healthcare professionals, looking at the person’s diet, medicines, and physical health, and made changes where necessary. This led to the person’s stability improving and their number of falls reducing.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People were involved in decisions about their care and staff sought permission to provide people with care and support. Staff understood people’s right to refuse care and the importance of gaining consent.

If a person appeared to lack the capacity to make an informed decision and communicate their choices, staff completed a mental capacity assessment, held a best interest meeting, and where applicable, applied for a Deprivation of Liberty Safeguards (DoLS) authorisation. A relative told us, “[Person] gets their DoLS reviewed annually, and we are included in that, and we have copies of everything, but we get a review every month, they are always asking about things and what needs changing.”

Records showed DoLS applications were tracked and monitored to ensure they were being managed correctly. The local authority’s DoLS team visited the service regularly to review assessments and make sure the service were adhering to the conditions stipulated in people’s DoLS authorisations.