Oakham 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 assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 and relatives told us people’s needs were assessed and they were kept informed when changes occurred. One relative said,“We did [Person’s] care plan and it’s been updated. [Staff] keep me up to date on any changes.” Another told us, “I’ve seen [Person’s] plan and I’m informed of every update. [Staff are] very good at explaining and communicating.”

Staff told us they were involved in regular discussions and reviews about people’s needs. One staff member said,“All Care plans are accessible electronically, and we are encouraged to read and update them regularly. Time is allocated during shifts to review them, especially when and after updates or changes.”

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.

The provider used recognised tools to assess and identify risks to providing people’s care and support. This included the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. Using the IDDSI, care plans clearly identified how some people needed their food prepared to reduce their risks of choking. Supplementary food charts and daily records completed by staff, accurately recorded people’s food intake.

Kitchen staff told us they were informed about people’s nutritional needs and updated if those needs changed. This included in relation to any modified diets, allergies or weight loss.

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.

Staff described strong teamwork and mutual support across the service. They worked effectively with health and social care professionals, including community falls teams to ensure care was tailored to people’s needs. They discussed how the range of training provided assisted them to deliver good care and support.

Feedback from visiting professionals was mostly positive regarding collaborative working. One external professional told us, “Where issues have arisen, the team have been very responsive and open to support.” However, another said “General feedback is that recommendations are implemented and followed for a period but not always maintained in the longer term as other internal changes occur within Oakham Grange.” The provider told us the service had undergone a period of staff changes since the last inspection to support improvements and help ensure these were sustained over time. This had resulted in changes to staff roles and responsibilities within the service to strengthen oversight, accountability, and the delivery of care.

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.

People had access to regular GP ward rounds and timely nurse-led reviews when they became unwell. Records demonstrated healthcare professionals were involved in monitoring people’s health needs and staff responded appropriately to changes in people’s wellbeing to ensure they received effective and responsive care.

People’s nutritional needs and preferences were assessed and well understood by staff. Staff had a good knowledge of people’s preferences and dislikes regarding food.Most people and their relatives were positive about the food in the home and how their nutritional and hydration needs were met. One person told us, “I’m quite happy with the food and we get choices for all the meals, and they just ask us beforehand. There’s a box with biscuits in the lounge for snacks or there are some things in the coffee lounge so we can just help ourselves.” A relative said, “They have a choice every day. They seem to love the food. [Relative] has put on a few pounds since being there.”

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 told us they felt theirs’ and their loved ones’ health needs were monitored safely and appropriately. One relative said, “He had [opticians] come in to check [person’s] eyes and have done [person] some better glasses. The Parkinson's nurse comes here to visit. [Person] gets the chiropodist here too.”

Records reviewed confirmed people’s health and care needs were monitored in line with their assessed needs. Information was used to inform reviews and ongoing care planning, helping to ensure people received appropriate support.

Staff demonstrated good knowledge of how to monitor people’s health effectively and were clear about the actions to take if someone became unwell, ensuring prompt and appropriate responses. One staff member told us, “Even if it is something small, I do not hesitate to take nurse's opinion because acting upon it quickly helps prevent things from getting worse.”

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

The Mental Capacity Act 2005 (MCA) establishes the legal framework for decision-making on behalf of individuals who may lack the capacity to make specific decisions themselves. The MCA requires that, wherever possible, individuals are supported to make their own decisions. When a person is assessed as lacking capacity for a particular decision, any decision made on their behalf must be in their best interests and represent the least restrictive option available. Where individuals were assessed as lacking capacity, mental capacity assessments had been completed.

People and their relatives told us staff always asked for consent when they were providing support. One relative told us, “[Person] is not in a position to give consent, but they behave as if [person] is. ‘Do you mind’, ‘would you like’. They do communicate with [Person].”

Staff had completed training on the MCA and demonstrated a clear understanding of its principles. Where people required assistance with decision-making, staff were able to tell us how they applied best-interest decision processes and ensured that any actions taken were the least restrictive option. One staff member told us,“We make sure that you help the person to make decisions about their daily care needs and carry out MCA if cognition declines. We know how to best support people in the least restrictive way.”