Castle 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 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.Care plans detailed people’s assessed needs. Staff and leaders were committed to reviewing and updating them to confirm their accuracy, to reflect changes in people’s circumstances and ensure timely access to medical support where needed. For example, following the identification of a new risk for one person, staff updated their care plan to include appropriate safeguards.
 

The provider 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 and current evidence-based good practice and standards. Where risks were identified, staff used recognised assessment tools, including the malnutrition universal screening tool (MUST), and worked with healthcare professionals to monitor needs and effectively manage risks. People with eating and drinking difficulties had care plans that clearly described the support they needed, including any dietary adaptations, to help them eat and drink safely and meet their assessed needs.

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 provider held weekly multidisciplinary meetings with community healthcare professionals, including GPs and the community matron, to discuss emerging concerns, review people's health needs and monitor the effectiveness of prescribed medicines. One healthcare partner shared, “Staff know the residents very well and demonstrate a good understanding of their individual needs and usual presentation. They are able to identify changes and raise concerns appropriately, allowing early intervention and reducing the risk of deterioration.”

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.
The manager identified trends in weight loss and responded proactively by reorganising staffing arrangements at mealtimes to ensure people received timely support with eating and drinking. This included deploying additional staff to assist people in bed or those requiring one-to-one support, helping to reduce delays and improve mealtime experiences. Staff took time to understand people’s backgrounds, interests and preferences so care could be tailored to their individual needs, while encouraging people to maintain good nutrition, hydration, mobility and involvement in meaningful activities. We observed people joining in with chair-based exercises and activities and staff talked enthusiastically about how they supported people to join in or for those who could not access activities in the lounge, they ensure they spent 1-1 time with them in their bedrooms.
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.
Staff completed food and fluid intake records and repositioning charts for people whose assessed needs required this support. The manager identified some monitoring was not proportionate to people’s needs and introduced a more person-centred approach, ensuring monitoring was only implemented where clinically indicated and care plans were updated accordingly. Nurses maintained oversight of monitoring over a 24-hour period and shared relevant information through handovers to support continuity of care. The manager completed regular nutrition audits to identify trends and drive improvement.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.People were supported to make decisions about their care and treatment wherever possible. Mental capacity assessments had been completed where needed and were decision-specific, involving people and those important to them in the process. Staff demonstrated a good understanding of seeking consent before providing care and described how they adapted their communication approaches to meet individual needs, especially those people with communication differences.