Everdale 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 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 their individual physical, mental and wellbeing care and treatment needs assessed. Recognised clinical assessment tools were used to assess and review people’s care and treatment needs such as skin care and dietary and hydration needs. Clinical care and treatment systems and processes were in place that continually monitored needs to review progress and actions. This supported staff to provide effective care based on best practice guidance.

Care plans provided staff with detailed guidance of how to meet people’s care and treatment needs. Care plans were regularly reviewed to ensure guidance continually reflected people’s changing needs. Where possible, people and relatives were consulted and involved. People’s communication needs were recorded to promote effective communication. We found care plans were well detailed, up to date and supportive to staff.

People and relatives confirmed they were involved and consulted about care and treatment needs. Changes to care and treatment was discussed.

Staff told us how they accessed electronic care plans and care records to review guidance of how to meet people’s individual needs. Staff were positive about information being sufficiently detailed and up to date. A staff member said, “Information about people’s care needs is very detailed and kept up to date. We discuss any changes to people’s needs in the daily ‘huddle’ meetings, and we always have the nurse, unit manager or team leader we can ask, if we are not sure about anything.”

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.

There were qualified nurses available at all times. Appropriate observations were carried out when people presented as unwell. A nationally recognised early warning tool was used to identify when people’s health was deteriorating and this directed staff about what action staff should take. People were referred to health care professionals quickly and staff followed their advice.

People’s dietary needs, including cultural needs, and preferences were assessed and planned for. We observed people had a positive mealtime experience. Staff created a calm and social atmosphere. Staff supported people in a sensitive, unhurried way. A menu displayed what choices were available. The lunch time meal appeared appetising and well presented.

Kitchen staff were aware of people’s individual dietary needs and preferences. The menu was based on feedback received from people and was reviewed and changed periodically. Food stocks and storage was good and reflected best practice guidance.

Staff spoken with knew about people’s dietary needs. People had their risk of malnutrition and dehydration assessed. Where risks were identified, care plans were in place and staff followed these. For example, staff knew what each person’s fluid target was for each day. Some people had been referred to a GP and dietician and were prescribed additional supplements. Care plans were in place for specific dietary needs such as diabetes. Staff monitored people’s weight where this was required and took action when required to. Some people preferred to have their meals in their rooms and staff supported them to do this.

People told us they had a choice of drinks and meals and how snacks were offered during the day and evening.

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 had systems and processes that supported the exchange of information about people’s care and treatment needs with others.

Staff told us they worked as a team and described how they consulted with other professionals and followed their advice. Recent changes had been made to improve communication with visiting healthcare professionals. The GP visited the service twice weekly. There was an MDT (multi-disciplinary team) approach in supporting people to achieve positive outcomes.

We spoke with 4 external professionals visiting the service. They were positive about how staff worked with them and together to provide effective care and treatment. There was also recognition of recent changes implemented by the provider to improve communication. A professional said, “ABC records (details of periods of emotional distress impacting a person) are completed really well, there has been some improvement here, they're much more in depth so good learning. I don't have any concerns I think there has been some lessons learned, and improvements made.”

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.

Some people were discharged from hospital for a period of reablement and rehabilitation. Staff worked with therapists based at the service to support people to gain greater independence and either return home or to an alternative placement.

When people either chose to remain in their bedrooms or where people received care and treatment in bed, staff were allocated to provide regular checks on their health, safety and wellbeing.

People had access to chair based exercise sessions and were supported to take walks around the grounds. Meals provided were nutritious and people had access to fruit daily.

People were supported to access health services. Feedback from people confirmed how well staff supported them with their health and well-being needs. A person said, “They’d [staff] get me a doctor if I needed one. I see the doctor quite regularly come for other people.”

External healthcare professionals were positive how well staff knew and understood people’s individual needs. Comments included, “When I visit, staff are well organised, prepared and planned for my visit, I'm provided with the information I need. I have no concerns about how people are supported with their health and wellbeing.”

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.

The provider’s electronic records system alerted staff if any care interventions had not been completed or if people had not had enough to eat or drink. Care plans were reviewed at least monthly and updated if people’s needs had changed. The provider had robust systems and processes that monitored clinical care and treatment needs. Treatment needs were continuously reviewed and monitored; records confirmed actions had been taken to support people to achieve positive outcomes. For example, skin wounds and pressure sores were effectively managed resulting in healing and recovery.

A relative told us how much their family member’s wellbeing had improved since moving into the service. A person told us how staff were assisting them with exercises to support them with their mobility. They advised how they had asked for a consistent team of staff, and confirmed their request had been fulfilled and their goal was being achieved.

The registered manager was a trainer in dementia care including emotional behaviours that could impact a person’s mood and behaviour. They described how through collaborative working with the clinical team and external professionals, incidents of distress had significantly reduced for one person.

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

Staff had received training on the Mental Capacity Act (MCA) and understood the MCA principles. For example, staff we spoke with understood their responsibility to gain people’s consent before any care intervention. Staff told us they always explained what they were doing and asked for consent or used non-verbal cues to ensure the person was happy for them to proceed. Staff respected people’s right to refuse any care or support. We saw staff gaining consent before providing any care or support throughout our visit. Staff also told us about how they may support a best interest decision such as if a person was unable to choose what clothes to wear. However, they were aware bigger decisions had to be formally assessed, and best interest decisions made in consultation with others such as relatives and external professionals.

Where people lacked the mental capacity to consent to a specific decision about their care and treatment, MCA assessments and best interest decisions had been completed. These documents clearly recorded how the assessment was completed and who was consulted. Best interest decisions recorded how the least restrictive option had been considered.

Where people had DNACPR (do not attempt cardiopulmonary resuscitation) or advanced decisions about their care and treatment, this was known and recorded and staff informed.