Good Shepherd 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

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.

This is the first assessment for this service. This key question has been rated 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’s care plans were kept up to date with any reviews completed in a timely manner. However, we found a lack of consistency in some of the daily records for people, which left people at risk of potential harm. For example, repositioning and wound management plans for people lacked clarity and did not provide clear guidance for staff to follow.

People and their relatives were confident that their needs were understood by the staff team. One relative told us how caring the staff were and how well they were looking after their family member. They told us, “My family member has had one of those special ‘rippling’ air beds since day one. They have been in bed all the time since June when they got bed sores from a hospital stay. Here the staff hoist them and that seems to be done fine. They get turned on a regular basis too.”

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.

People and their relatives were positive about the therapeutic support provided for them by the staff team. One relative told us, “My family member is more content here than at their last care home. The physio has made a real difference, my family member raises their legs more, their hands open up now and we can move their fingers. My family member can move their head from side to side. They try to talk sometimes, much more often nowadays.”

The registered manager and staff team showed extensive knowledge, and experience, of supporting people living with neurological rehabilitation needs. Care plans we reviewed showed best practice guidance was followed by the service. People’s unique needs were clearly identified and care planned for. The service employed a physiotherapist, to enable people to work on maintaining and improving their mobility levels. The service had a dedicated gym area, which was used to support these rehabilitation exercises. An occupational therapist visited the service when required, to review equipment needs for people.

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.

We were told by relatives that the GP made a regular visit and could be called out as necessary. A chiropodist visited every few months, on request. An occupational therapist also visited by invitation to assess people’s needs if required. The in-house physiotherapist provided a personalised programme for residents.

People and their relatives were positive about the way the service worked with external agencies. One relative told us, “My family member has the chiropodist visit every few months. The GP will visit when needed. All is good."

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.

Food provision appeared to be tailored to each person’s needs. We could not assess the management and knowledge of the kitchen staff, as the meals were brought through from the kitchen of the adjoining service. Only a small number of people were able to eat independently, or take a soft diet by mouth, with full support from staff. A number of people were fed through feeding tubes in their stomachs; we saw staff were trained and competent to administer food in this way. Fluids were provided in lidded beakers for several people, most of whom required support with their intake.

Referrals for specialist input with support for people living with sensory needs had been made to external health teams. We saw the guidance given by these teams had been used to inform and update people’s care plans.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

We found a lack of consistency in the daily records for wound management and the repositioning of some people. This meant people were at potential risk of their skin management needs being unmet. The registered manager reviewed these promptly during our assessment and submitted an updated process to ensure these actions were completed. We will review the implementation of this at our next assessment.

People and their relatives were largely positive regarding staff being hardworking and understanding of their needs. Care plans were person-centred, and detailed people’s life experiences. However, not all relatives we spoke with had been involved in regular reviews of their family members’ plans of care. One relative told us, “We’ve never had sight of a care plan. We just did paperwork and they talked to us when my family member arrived here, about what they like. Our biggest concern since day one is that we’ve not been kept in the loop, both by the hospital and here. We didn’t know who to ask, we saw the manager, but we wanted more information. Today we’re seeing the GP here for the first time to find out what’s happening, as we’ve not been communicated with."

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

Staff asked people for their consent prior to providing personal care. Nobody raised concerns around feeling unnecessarily restricted and they explained how their preferences were respected. We observed staff asking and explaining tasks to people and asking if it would be ok to do this. A staff member also asked a person’s permission to speak with our Expert by Experience before they introduced themselves.

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.