GHC Nursing 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

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.

We assessed a limited number of quality statements in the effective key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was requires improvement.

This service scored 50 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People were not able to explain how they were involved in assessing their care and support needs. People had not been given the opportunity to have a holistic review of their physical, mental and support needs. This meant people were at risk of not receiving the best possible outcomes. Care plans and assessments demonstrated people were not involved in assessing their care and support needs. Staff reviewed care plans and assessments. However, the reviews were ineffective, staff had not identified that care plans were not reflective of people’s needs and not always identified people’s needs had changed. For example, where people had skin damage and required care and support, we found there was no care plan or a risk assessment in place for staff to follow. Another person was living with diabetes, and we found there was not a person-centred care plan in place for staff to follow on how to safely support the person with their diabetes. This placed people at risk of not receiving safe care and support to meet their needs and manage known risks. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, to have a clear understanding of the person’s needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People did not always receive adequate support with their nutrition and hydration in line with current standards. For example, we observed people were left in their bedrooms with food and drink in front of them and they required staff support and supervision. This was then taken away from them with very little eaten. Staff failed to provide us with assurance on what action they would take when people did not eat much or drink enough. Staff told us, “We tried but they were not eating.” The staff did not offer any other meals or take appropriate action to try later. Furthermore, we found people who were supported with their early morning personal care, 1 person out of 9 had received their breakfast. Everyone else had to wait for the shift change to be supported with food or a hot drink, this could have been up to 2 hours. This placed people at risk from poor nutrition and hydration.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff failed to apply and follow the Mental Capacity Act 2005 (MCA). The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People had not consented to their care plans and where people were deemed to lack capacity, relatives told us they had not been involved to ensure the information staff had was accurate on how people would like to be supported. During our visit, people told us they did not want to wake up earlier and were still tired, therefore people had not consented to receiving personal care early in the morning, before 6am. Where people were deemed to lack capacity to make their own decisions, we found the Mental Capacity Act had not always been followed to ensure best interest decisions were made by understanding people’s preferences, routines, which placed them at risk of task and staff focused care. Failure to ensure staff followed the MCA and people had meaningful best interest decisions in place increased the risk of people’s human rights not being respected.