Gracefield Health Care Limited (GHC) - 31 St Domingo Grove

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

Effective – this means we looked for evidence that people’s care,treatmentand support achieved good outcomes and promoteda good qualityof life, based on best available evidence.

At our last assessment we rated this key questionrequires improvement.At thisassessmentthe rating has changed togood:This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider did not always demonstrate through records that people received effective care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them. Although staff told us people were involved in these assessments and reviews, this was not consistently reflected in the documentation.

Care plans were detailed and contained person-centred information. However, for some people there were inconsistencies in how the plans were written. Some sections were documented in the first person using “I”, while other sections in the same plan referred to the person by name.

This was shared with the registered manager who responded promptly to provide assurances all care plans were being reviewed and would be updated to ensure people’s views were clearly recorded.

People’s care plans were reviewed and updated when required. Clinical assessment tools were utilised including food charts and any weight loss recorded to ensure people had a nutritional diet and to support weight management.

The provider worked collaboratively with people to plan and deliver their care and treatment, ensuring this reflected what mattered most to them. Care was delivered in accordance with legislation, as well as current evidence-based standards and good practice.

For instance, when appropriate, people had Positive Behaviour Support (PBS) plans in place. These plans focused on proactive, person-centred strategies designed to reduce distress and promote supportive environments. They were developed alongside the organisation’s consultant psychologist and other health professionals involved.

Nutrition care plans were in place and included guidance that reflected current best practice. Where a person made an unwise decision regarding their diet, this was clearly documented within their care plan. The plan also outlined the actions staff should take to provide safe, proportionate and person-centred support in response to this.

Evidence showed the provider worked effectively across teams and services to support people. Multi‑agency meetings, joint working practices, care plans and regular discussions with staff enabled people’s needs to be shared seamlessly, meaning people did not have to repeat their story when moving between services. Communication with external health and social care partners was consistently recorded, and there was documented evidence of weekly involvement from the consultant psychiatrist, further supporting coordinated and informed care.

Internal communication was effective due to the provider identifying ways to ensure all staff could provide feedback, meetings over teams enabled those staff who could not attend the service t to share their views.

The provider supported people to manage their health and wellbeing in ways that maximised their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future need for care and support. This was underpinned by effective multiagency working with community psychiatric nurses (CPNs), social workers and their own inhouse psychiatrists, ensuring people received coordinated, person-centred and timely support. Professionals shared information appropriately and worked together to anticipate risks, promote wellbeing and deliver consistent care that met people’s holistic needs. One professional shared with CQC, “The support and care offered to some of my patients by staff under their care is exemplary as it is indeed vital for their wellbeing in the community."

The service had systems in place to monitor changes in people’s health and wellbeing. Staff used clinical monitoring tools, behaviour support plans and additional risk assessments to identify any emerging concerns. This helped ensure people received timely and appropriate adjustments to their support when required.

Staff understood people’s needs well and were able to explain how support had been adapted in response to changes over time. Records showed this had contributed to people becoming more settled and experiencing improvements in their quality of life.

Relatives spoke positively about the care their family members received. One relative told us, “Other placements have not been successful; however, here [loved one] is settled and there have been noticeable improvements in their quality of life.” This feedback was consistent with what we found during the assessment and demonstrated the service’s effectiveness in supporting people to achieve positive outcomes.

The provider informed people about their rights around consent and ensured these were respected when delivering person-centred care and treatment. Mental capacity assessments were completed where required, and best interest decisions were made and recorded appropriately.

Applications for Deprivation of Liberty Safeguards (DoLS) were submitted when needed, and any conditions attached to an authorisation were clearly documented in people’s care plans. Protocols were in place for people who were subject to a DoLS but were still able to access the community, and staff followed these arrangements consistently.

People were supported to access advocacy services when required to help them express their views and wishes.