GHC Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

We assessed a limited number of quality statements in the responsive key question and found areas of good practice. 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 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. External health professionals involved in people’s care told us care was not always responsive. One professional told us, “We find guidance is not always followed and inconsistency of care. Equipment is not always fitted properly. We have shown staff, but this continues.” Another professional told us, “There are some concerns, mainly poor documentation for information collating; E.G (for example) inconsistent completion of food charts or incomplete dysphagia management checklists, meaning we have been unable to upgrade food consistency safely.” This meant there was a risk of people not always receiving continuity of care as needed.

The registered manager had told us after our visit they had had a meeting with one professional to improve their joined up working and provided them with access to their electronic system to support continuity of care.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Relatives and professionals raised concerns of not always being able to get in contact with the home. One relative told us, “I do have a concern, when I call no one answers the phone. I could not come to see [family member] I wanted to know they [family member] were ok.” A professional told us, “Poor accessibility to the home for communication, limited reading of emails sent to the home and limited access via telephone also.” This meant information was not always provided in a timely way and the home was not always responsive to communication.

People were provided information in a format they could understand. For example, one person’s first language was not English some staff had learnt the person’s language to enable effective communication. One staff member told us, “We have a person [name] who is not able to hear as well, we use a white board to write anything we need too, and they reply back to us.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. Relatives told us they knew how they could give feedback and told us they felt action would be taken. The registered manager told us they logged complaints and responded to complaints appropriately. A suggestion box was in reception area. Guidance on how to provide feedback was also contained within the service user guide.The registered manager told us plans to have a newsletter because recent relative meetings were not always attended and not effective.

The provider made sure that people could access the care, support and treatment theyneeded when they needed it.

Care plans considered people’s needs and any adjustments that could be made to ensure they had equal access. For example, people had mobility and communication care plans that detailed their care and support needs.All indoor communal areas of the home were accessible to people with all levels of mobility, including wheelchair users. Staff told us the home was accessible. One staff member told us, “The home has all the equipment needed, the showers have been adapted to ensure all people can have easy access.”

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Care plans were not always up to date and did not detail which health professionals were involved in people’s care, how often they visited, and their guidance not always recorded in care plan records. We found no information regarding people having the opportunity to continue with routine health care check-ups with professionals such as an optician or a dentist. This meant people were not always supported to ensure they had access to health services and treatment. Where professionals such as stroke nurses or a GP had visited, the visits were logged in people’s daily notes under medical, but the outcomes or advice had not been recorded in people’s care plans.

Whilst care plans were not detailed, staff felt they are made aware of any health changes through handovers. One staff member told us, “We find out what appointments people have on that day and the outcomes in the morning handovers.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. No one required end of life care during our visit. However, relatives told us conversations about end-of-life planning had taken place. We found people had detailed care plans including their wishes and staff had completed training in end-of-life care. One staff member told us. “When someone is receiving end-of-life care, we try to make them comfortable as possible pain free, provide lots of emotional support and keep people involved in as much as they can still do.”

Where advance care planning, Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) or Do not attempt cardiopulmonary resuscitation (DNACPR) were in place these were recorded in people’s care plans. These plans offered people the opportunity to plan their future care and support. This included medical treatment and resuscitation options, these conversations took place while they had the capacity to do so or in their best interest where appropriate. This meant people were supported to plan for important life changes.