East Dean Grange Care Home

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

People and their relatives spoke positively about the care and treatment they received at the home. People’s needs were assessed before they were admitted ensuring these could be appropriately met. Staff used tools to ensure evidence-based care was delivered, for example, waterlow scores were used to assess people’s skin integrity. Referrals had been appropriately made to external agencies to promote people’s health and wellbeing. People were given choice and control in daily decision making. Where people lacked capacity, the principles of the Mental Capacity Act (MCA) 2005 were followed and best interest decisions made when needed. There were some gaps in documentation, especially in relation to wound care. The registered manager and provider were receptive to our feedback in this area and had plans to make improvements.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us that their needs were assessed before moving into the home. Care and support needs were regularly reviewed. One person told us, “I have discussed my care plan, not had an updated version yet but it’s been discussed.” A relative told us, “His care plan was discussed and updated.”

The registered manager visited people to complete a full assessment of their needs prior to admission or readmission to the home. Staff told us that they were given time to get to know people who were new to the home or review any change in needs when a person returns from hospital.

Processes for assessing people’s needs were robust. Pre-admission assessments took place to ensure people’s needs could be met. During the site visit, we heard telephone calls where staff were clarifying a person’s mobility level prior to readmission and trying to ensure hospital was aware of what needs they could support. This included considering the layout of the home and whether the physical environment would be suitable for the person.

We received positive feedback about the support people received. A relative told us, “(Staff) recognise and identify if someone is unwell, they deal with them considerately and if the person is upset, they will comfort them.”

Staff told us how they used the knowledge gained from their training to support people appropriately. For example, they were able to demonstrate appropriate moving and handling techniques. The management team told us people’s care was regularly reviewed to identify any changes and this information used to shape their care and treatment.

Processes were in place to deliver evidence-based care; however, these were not always robustly followed. Records showed the use of nationally recognised tools, for example MUST for monitoring weight and Waterlow score for assessing people’s risk of pressure damage. However, we saw that when people had sustained wounds, staff were not recording details of the wound or following the training provided by the external healthcare professional. This is discussed in more detail in the ‘safe’ key question.

People and relatives told us staff worked with other services to ensure appropriate support was provided. “Staff called me as my [relative] was unwell, they were very quick and on the ball, very good.” Another relative told us how staff worked with healthcare professionals to improve their loved one’s health condition.

Staff worked well with external health and social care organisations to ensure people received effective care and treatment. They told us these good relationships help provide effective care and support to people. The documentation regarding these discussions were not always clear and accurate.

Feedback from external healthcare professionals was positive. They told us staff engaged with them and made appropriate referrals. They confirmed that this good working relationship led to better outcomes for people.

Processes were in place to ensure appropriate referrals were made to external agencies as required. People’s care plans and records mostly demonstrated that referrals and ongoing discussions took place regarding people’s health and social care needs. However, we did find some gaps in the documentation, especially around wound care.

People and their relatives were confident that people’s health needs were met effectively, and they were supported to live healthy lifestyles. They told us appropriate healthcare professionals were contacted when required. One person told us, “Chiropody, Hairdresser and GP available as necessary.” Another added, “I have been referred to an Optician and awaiting an ENT (ear nose and throat) appointment.” A further person said, “Any professional can be accessed.”

The registered manager and staff contacted healthcare professionals when people were unwell or if there were concerns about their well-being. They supported people to receive regular healthcare appointments such as chiropody and dental. The registered manager told us there was regular contact from the local GP practice. They told us visits from healthcare professionals were prompt in response to any concerns raised.

Processes were in place to support people to live healthier lifestyles. Where people required regular health checks, such as blood tests, related to their health conditions records showed that these were taking place. Healthcare professionals told us that staff contacted them appropriately when they had concerns. One healthcare professional said, “Referrals are sent in, and these are appropriate.” There were some gaps noted in people’s care plans especially in relation to wound care.

People’s care and support needs were continuously monitored to ensure good outcomes. One relative told us how staff had made changes to help improve their loved one’s skin condition. They told us, “Clothes are washed separately in non-bio and we have seen an improvement.”

Staff and management monitored people’s care and support through regular reviews, audits and discussions. This included clear information sharing at regular handover meetings. Staff told us about positive communication about changes to one person’s support which had resulted in a reduction in their falls.

There were processes in place to ensure that people’s care and support were regularly reviewed and updated. The registered manager completed audits of care plans to ensure they were up to date. Some information was missing, for example, wound care. This was addressed following the site visits for the assessment.

People and their relatives were able to make choices. One person told us, “I’m better off here than being on my own at home, I get choices to a point, you can’t have everything in life.” Relatives reported that their loved ones consented before care was delivered. They had also been involved and informed when Deprivation of Liberty Safeguards (DoLS) were required.

Staff ensured that people were given choices throughout the day, and they gained consent before delivering care. One staff member told us that although they were busy they ensured people were given choices about what they would like to do each day. Discussions with staff demonstrated they understood consent and how they respected people’s choices and decisions.

Processes were in place to ensure people’s consent was gathered and documented. Where people were deemed not to have capacity, Mental Capacity Assessments and best interest decisions had taken place to ensure decisions made were in the best interest of the person. This included the use of sensor beams when people were identified at the risk of falls. The registered manager had clear oversight of Deprivation of Liberty Safeguards (DoLS), including when these were applied for, authorised and any conditions associated with them. There was information about how conditions had been complied with.