Grange House

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 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff worked hard to ensure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff understood peoples needs and ensured any changes were referred to the GP or specialists involved in the person’s care.

Although people had care plans in place for identified needs, information detailed did not always correspond to other areas of documentation. For example, PEEPs information needed to be reviewed and updated for new admissions. Some reviews and checks were highlighted as overdue on electronic care documentation.

Information about people’s life history was not always consistent throughout their care documentation which could lead to confusion. One person’s working life had not been recorded accurately throughout their care documentation. This could cause confusion if staff spoke to them about their past and used incorrect information.

Care plans were accessible to all staff providing support. Pre-admission assessments were carried out by senior staff to ensure the service could safely meet peoples care needs and information was shared during handover at the start of each shift to keep staff updated regarding any 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.

Staff had received dementia awareness training and demonstrated an understanding around dementia type illness and how this may impact on a person’s mental health. People’s preferences were noted and staff delivered person centred care. One person who had recently moved into the home had information recorded in their care documentation regarding their preferences. This included information regarding their choice to have female care staff assisting with personal care, and their food preferences. Relatives confirmed they were asked for information about peoples likes and dislikes

People had a choice at mealtimes and were supported to have a balanced nutritional diet including any specialist requirements, for example low sugar alternatives and softer pureed meals. Relatives confirmed that meals always looked appetising and there seemed to be a variety of meals on offer when they visited. Catering staff had worked at the home for a long time and were familiar with people’s individual needs.

The provider and care staff liaised with other teams and services to ensure people received the right support. Staff understood peoples care needs and information was shared with other agencies as required.

Care documentation included details of teams and specialists providing support as part of the ongoing management of long-term health conditions. For example, people with diabetes received support from community nursing teams and those who needed care from the mental health team had this provided. One visiting professional told us, “The staff themselves are warm and welcoming and are always very helpful when I have questions or need information on a new resident and their 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 and where possible, reduce their future needs for care and support.

During the inspection we observed staff contacting GPs and speaking to health professionals involved in people’s care. When people’s health needs had changed referrals had been completed, this included Speech and Language Therapy (SaLT) OT and GPs.

Staff consider peoples choices and support them to maintain as much independence as possible. We observed staff giving people time to mobilise, offering reassurance and support when needed.

Care staff monitored people’s care and treatment to continuously improve it. Any changes were discussed with the provider. Care staff ensured that outcomes were positive and consistent. However, we did find that some areas of documentation needed to improve to ensure all interactions and reviews were consistently documented, this included people’s weights and daily charts.

In the absence of a manager a number of care staff had been making changes to care documentation, this had led to some discrepancies. Some care plans needed to be reviewed to ensure all monthly checks and actions had been completed.

Relatives told us when their loved one moved into the home staff had asked them for information about the person and their mobility, health and care needs. As staff got to know people, information was discussed in handover to ensure all staff were aware of people’s needs.

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

Care was person centred. Staff understood the importance of involving people in day-to-day choices and supported people’s right to make their own decisions. We saw people being offered choice about what they ate and how they spent their time. Staff sought consent before any care was provided.

People’s mental capacity and ability to be involved in choices and decisions was included in care records and best interest decisions had been documented when appropriate.