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.

At our last assessment we rated this key question requires improvements. 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 67 (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 always able to explain how they were involved in assessing their care and support needs. Since our last visit not everyone had 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. The clinical lead told us; they would contact everyone and provide them with the opportunity to be part of their care plan review.

Assessments demonstrated care plans had been updated since our last visit and staff knew about people regarding their assessed needs. Pre-admission assessments included information around people’s healthcare needs, preferred communication methods and how to best support people. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people in their chosen way and to have a clear understanding of the person’s needs.

The provider delivered people’s care and treatment and did so in line with legislation and current evidence-based good practice and standards. For example, staff used nationally recognised tools to support people. Such as the Malnutrition Universal Screening Tool and the Waterlow Assessment Tool. These tools are used to identify risks and concerns. People’s nutrition and hydration needs were supported in line with current standards. We observed an improved mealtime experience that was relaxed and unhurried. Where people had declined their meals, alternative options were offered based on their likes. For example, a person did not like their hot meal and declined to eat it, staff offered them options from what they knew they liked and picked a cheese sandwich. One person told us, “I get a cup of tea every time I shout up. I get food whenever I want. I can have it wherever I like. There’s lots of choice of food.” People who required monitoring on how much they had drunk and eaten, had electronic records in place for staff to complete and these were reviewed to identify any risks. We observed people’s wishes and choices were respected regarding the times they wanted to wake up and have their breakfast.

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. Care plans demonstrated staff worked closely with other health and social care agencies such as the local authority. Management told us they worked well with other health professionals and obtained any health advice when needed and ensured it was followed. The deputy manager was able to explain when other health professionals would attend and the reason for the visits. There were effective processes and systems in place to allow the staff team to work together. For example, handover records were in place and used by the staff team to share information and updates. Staff told us they worked together as a team and the deputy manager supported them at busier times such as mornings and mealtimes to help the team ensure people received their care. Staff told us they worked well together. One staff member told us, “I believe our team works well together, because there is effective communication, mutual respect and trust amongst team members, shared goals and commitments to providing excellent care, supportive leadership and guidance, regular team meetings and feedback.”

People’s needs were assessed to identify any concerns regarding their health and wellbeing. Staff knew people well and could explain how they supported people to live a healthy life and provided meaningful activities to support people’s well-being. The provider had recruited an activities staff member who was employed to plan and provide people with meaningful activities to ensure their hobbies and interests were maintained. We saw people looked well and cared for. Staff told us they supported people to live healthier. One staff member told us, “I 'have supported several residents in improving their lives and health, one example is a resident who struggled with mobility I am working with them to, encourage regular physical activity, providing support and motivation.”

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. There was a process in place called resident of the day. Every day a different person’s care, and support needs were reviewed. Where people required monitoring with certain aspects of their care such as fluid intake, the staff team monitored this to ensure people were having enough fluid. Accidents and incidents including falls were reviewed, with clear analysis for trends and themes and actions taken in a timely manner following each event.

The provider did not always tell people about their rights around consent. Staff did not always 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 decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Mental capacity assessments had been completed; however, we found they did not always follow the five 5 key principles to prove someone lacks capacity. This meant people were at risk of having decisions made unlawfully. The manager told us they were aware further work was required, and some paper-based assessments would have had the detail, however this had not been transferred onto the new electronic system. Staff had been provided with training. One staff member told us. “Consent means obtaining permission from a person before providing care or support. To gain consent I would, explain the care in a way the person understands, ensure they have capacity to make the decision, Respect their decision, whether it's yes or no. If a person lacks capacity to give consent I would, follow MCA principles, consult the family members, make best interests decisions, prioritising their wellbeing and safety.”