The Garth Care Home with Nursing

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 inadequate. At this assessment the rating has changed to 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.
A relative told us, “I have seen copies (of their relatives care plan) and the family have been involved in her care plan, Mum is not able to make choices about her health or wellbeing.”
The Registered Manager had systems in place to ensure people's needs were regularly assessed and reviewed. This included an audit programme for reviewing care plans and a "Resident of the Day" system, which provided a structured approach to reviewing individual care records, assessing whether support remained appropriate, and gathering feedback from people and those important to them. This helped to ensure care remained responsive to people's changing needs and preferences.
We reviewed a sample of care plans and found they contained detailed, person-centred information about people's assessed needs. Records included information about people's life histories, communication needs, personal care requirements, health and wellbeing, hobbies and interests, eating and drinking needs, and the support required with medicines. Care plans provided staff with clear guidance on how to support people in a way that reflected their individual preferences and circumstances.
Staff demonstrated a good understanding of people's needs and were able to describe how care and support was tailored to people. This helped to ensure people received care that was consistent with their assessed needs and personal preferences.
 

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.
We saw evidence that the service used recognised assessment tools and frameworks to support the delivery of care. For example, records demonstrated the use of the International Dysphagia Diet Standardisation Initiative (IDDSI) framework to guide the safe management of modified diets for people at risk of choking. This helped to ensure dietary requirements were clearly identified and consistently followed.
Since the last assessment, the provider had hired a new Head Chef. During the assessment, we spoke with them and they were able to clearly identify individuals who required modified diets and demonstrated a good understanding of dysphagia and the importance of adhering to dietary guidance. Observations of staff showed they followed nationally recognised guidance to prepare meals to the correct consistency to reduce the risk of choking. This contributed to reducing risks and supporting positive health outcomes for people using the service.
 

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.
People told us that staff worked effectively with other professionals to ensure they received consistent care and treatment. One person told us, “The Doctor visits and I can see them when needed, I also see the chiropodist and staff help me with appointments”.
One relative told us, “[Relative’s name] own GP comes into the home to see her once or twice per week, as they are quite poorly, she also sees the chiropodist and hairdresser.”
Visiting healthcare professionals also reported that communication between teams was good.
Professionals told us that support staff work well with them. One professional told us, “Staff were very engaged, took on advice and communication is very 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.
One person told us, “Activities are good, recently had a singer and pizza night, I just do everything that happens, I enjoy it”. One relative told us, “The home does have good activities and try to encourage residents to engage.”
The home has an activities co-ordinator who ensures the activity planner is reviewed and updated regularly. People’s wishes and choices are taken into consideration when this is being reviewed. The registered manager also meets with them to review the planner weekly.
The home’s food menu was reviewed quarterly with involvement from residents. Catering staff sought regular feedback about the meals provided, we received positive feedback overall regarding the food on offer. One person told us, “Food is great, couldn’t wish for better, you get a choice of food, we have a menu in the evening, and the food arrives the next day.
Records showed people had access to appropriate healthcare services, and information from appointments was documented and used to inform care planning. Staff demonstrated an understanding of people's health conditions and were able to describe how they monitored for signs of deterioration and escalated concerns when required.
 

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.
Effective systems were in place to monitor people's health outcomes and identify changes in need. The electronic care management system generates alerts relating to key indicators, including nutrition, hydration and weight management, supporting staff to take timely and appropriate action.
The registered manager had clear oversight of care delivery and used monitoring information to review performance, identify trends and provide assurance that care was being delivered as intended. Records reviewed during the assessment were consistent with the requirements set out in people's care plans.

Monthly clinical review meetings provided a structured forum for discussing people's wellbeing, monitoring outcomes and considering whether any changes to care or support arrangements were required. This demonstrated a proactive approach to evaluating care and driving continuous improvement.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
The home was working within the principles of the Mental Capacity Act 2005 (MCA). Care records we reviewed contained mental capacity assessments and demonstrated involvement from individuals and, where appropriate, those legally authorised or important to them in decision-making processes. Where people were assessed as lacking capacity to make specific decisions, best interests’ decisions had been recorded to support care and treatment arrangements.
We identified that further consideration was required regarding the use of more decision-specific mental capacity assessments, rather than relying on broader overarching assessments. The Registered Manager was receptive to this feedback and acknowledged that a review of existing assessments was needed, to ensure they fully reflected the decision-specific requirements of the MCA.
The provider was also working within the principles of the Deprivation of Liberty Safeguards (DoLS). Records showed appropriate applications had been submitted to the local authority where required.
Systems were in place to monitor the status of mental capacity assessments and DoLS authorisations, helping to ensure these were reviewed and updated when necessary and that people's rights were protected in accordance with relevant legislation.