Gracefields 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 good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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’s health, care, wellbeing and communication needs were assessed, and staff checked these regularly to make sure the support was appropriate for them. The manager told us that the care plans were reviewed often and that friends and relatives gave verbal feedback to help with this. They also told us that they spoke to people and passed on any requests to staff, for example if a person wanted personal care at a different time. The manager said they used their daily walk‑around to watch interactions for people who did not have capacity. Any findings were then shared with staff, if needed.

Records in relation to people’s weights were recorded in each person’s care plan, and any weight loss was followed up with the GP so possible causes could be explored.

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.

Staff monitored people’s food and fluid intake when needed and shared clear information so everyone knew how to keep people well. Kitchen staff had up to date information about people’s allergies, textured‑diet needs and cultural preferences, such as preparing halal meals. People were given choices at mealtimes, and if they changed their mind, staff offered suitable alternatives so they could make informed decisions.

People’s care plans showed that they were involved in planning their care and support. For example, a care plan for a person with diabetes clearly explained what they could do independently, what they needed help with, and what mattered to them. It also set out the associated risks linked to their health condition and what staff should do if their blood sugar became too high or too low. During mealtimes, people were encouraged to eat independently where possible, and staff supported them gently when needed. This helped to ensure care was delivered in line with good practice and people’s own preferences.

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.

The discharge process was robust, with clear documentation of people’s medical history, upcoming appointments, continence assessments, body maps and a record of personal belongings. Information was coordinated and shared with other teams involved in people’s care. Clinical and heads of department meetings took place regularly and highlighted any potential risks.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s dietary needs were managed safely, including for conditions such as diabetes and staff adapted the way they supported people when usual routines were difficult. One family member explained that staff helped their relative feel more comfortable in their room by adjusting the temperature when they were struggling to settle at the service. This helped them stay as independent as possible. People were supported to eat and drink in ways that suited them and staff took time to understand what mattered to each person. One person told us, “Staff really know what he wants and what he likes” and shared that their family member’s appetite had improved since moving to the service.

Care plans for people with health conditions such as Parkinson’s, diabetes or seizures were clear and staff made referrals to external health professionals when risks were identified.

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 themselves.

The service used a Believing in the Best Record (BIBR) initiative. This was to support people to focus on personal goals that were important to them, with staff and partners working together to create personalised plans. Each person has an activity buddy, which was recorded in their care plans. Progress and behavioural charts were updated to assess people’s suitability. When possible, the service tried to match people with others who shared similar interests.

People and their relatives shared examples of how the staff had supported them to improve their health and wellbeing. One person told us, “I was a diabetic, now in remission in the last 5 years".

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s views and wishes were clearly reflected in their care plans. Staff used expression cards to help people who found communication more difficult share their preferences and to make choices.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular 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. We found the service was working within the principles of the MCA. Mental Capacity Act assessments showed that families were involved in decision‑making where appropriate and that the less‑restrictive options had been explored before any restrictions were agreed.

72% of staff had completed training on consent, giving them the knowledge to support people to understand information and make their own decisions wherever possible.

Systems were in place to check whether people had the capacity to make their own decisions, and to make decisions in their best interests when they were unable to. The provider made sure people understood their rights about giving consent, and these rights were respected when staff delivered person‑centred care. Staff knew how to ask for consent properly and had training that helped them support people with decision‑making whenever needed.