Gloucestershire House - Care Home with Nursing Physical Disabilities

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 changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.
 

This service scored 58 (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 were assessed by a member of staff before moving to the service. A staff member said, “We meet people face to face, we assess their needs, and see what other support is involved. We invite people to come and look around with their family.”

Care plans were reviewed monthly as part of “resident of the day.” One staff member said, “We review the care plan with the resident, check that they are happy with their care and look at what might not be going so well. It’s their chance to speak up.”

One person told us; “(Staff) Go through my care plan with me, always checking with me if I am happy or if I need anything else in the way of care.”
 

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.

The service used nationally recognised assessment tools to assess people’s risks and support needs. Records showed there were good links with external health professionals, and we saw people had been referred for specialist support and advice when needed.
 

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.

Staff told us communication within the service was good. They said there were daily meetings with a staff member from each department attending. This enabled key messages to be shared and then escalated to staff within wider teams. One staff member said; “At the start of each shift we have a handover.”

Staff worked with a range of health professionals. Referrals were made when needed.

A healthcare professional working with the service told us; “They [staff] respond promptly to requests for updates and always accommodate my planned visits.”
 

The provider supported people to manage their health and wellbeing, so people could maximise their independence, choice and control. However. staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Not all care plans included information for staff on how to support people to live healthier lives. For example, diabetes plans did not consistently include information for staff on how to identify signs of low or high blood sugar levels or what the person’s normal blood sugar for that person was. Staff told us they knew how to raise concerns with the nurse on duty if they were worried about someone.

People told us and records showed they were supported to attend healthcare appointments. One person told us, “The staff arrange transport, and staff always take us to any hospital appointments.”

People were encouraged to be active and take part in exercises supported by the on-site physiotherapy team. One person told us, “I see the physio for exercises and my PA [personal assistant] does my nails and hand massage.”

Feedback about the food and drink provided at the service was generally positive. One person told us “The food is very good. We have been asked about the food we like and the menu, so we are involved with that.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. People’s care plans were not completed in line with the provider’s policy. For example, wound measuring tools were inconsistently used which meant it would be difficult for staff to easily identify if people’s wounds were improving or deteriorating. We fed this back to the management team who advised they would address this with staff.

When people were unwell, records showed that health professional support was sought in a timely manner. One person told us, “When I've been ill, they've responded quickly and got me to hospital quickly.”

People’s relatives confirmed staff contacted the doctor if people became unwell.
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

There were records in place which showed people had been asked to consent to having their records shared with other professionals. However, people’s consent was not always respected. For example, we were given access to a person’s records without their permission, despite them requesting permission was always sought.

Records related to mental capacity assessments (MCA) and best interest decisions were yet to be moved on the electronic system and were not consistently completed in line with legislative requirements. For example, records did not demonstrate that all required elements had been considered when completing the assessment or that less restrictive options had been explored. We also found an example where information relating to another person had been included in an individual's MCA and best interest records.

Mental capacity assessments and best interest decisions were not being reviewed consistently in accordance with the provider's policy.

Staff demonstrated an understanding of the principles of the Mental Capacity Act and the importance of seeking people’s consent prior to supporting them. Feedback we received indicated that staff were routinely seeking consent from people before providing care and support.

One person told us; “They [staff] do always ask me, and they do tell me what they are doing. When they get me up is my choice. I can choose what I want to wear.”