Grace Care 24/7 Ltd

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• 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.

This is the first assessment for this newly registered 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 were assessed before a package of care was agreed and this assessment included people and their representatives as they wanted. Records relating to this assessment were not full and did not record all people’s care and health needs. This was identified to the registered manager and the director’s immediate action was taken to ensure these were reviewed and updated records were recorded on the new computer care system that staff had access to. The impact of poor records was limited as staff knew people well and the number of people receiving support was small. The full and effective assessment of people with suitable records needs to be embedded into everyday practice to support safe and effective care.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Records did not fully support the plan of care and treatment, along with providing clarity and identification of people’s individual needs and wishes. For example, health histories that impacted on people’s health and mobility had not been fully recorded. Medical conditions including diabetes had not been addressed with a record of evidenced-based care if required. Therefore, the provider could not be assured these were responded to effectively. The registered manager and directors recognised further improvements were needed to support individual and personalised care and to ensure everyday practice supported the delivery of appropriate care and treatment.

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 registered manager and directors liaised effectively with other health and social care services to promote continuity of the care and support provided. Staff contacted them quickly if they noted any changes in people’s health or needs and these were responded to effectively.

For example, staff monitored people’s skin to identify any changes. One relative told us, “They recognised their skin was breaking down and raised it with me and the manager. I was asked to contact the GP for advice.” Health professionals told us, “We have a good working relationship with the managers who contact us when needed.”

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Although care records did not always provide staff with information and guidance. Staff knew people well, and they were able to pick up signs if people were unwell or in pain or showing signs of infection. These were raised with the family and the managers as necessary. One relative told us, “Staff notice any changes and report right back to me.”

Staff supported healthy options when able. For example, staff encouraged and monitored fluid intake and output for people with a urinary catheter to reduce the risk of urinary infections. Health care professionals told us the reduction of urinary infections had been noted.

Staff supported people to access services for their health care needs. For example, staff ensured people were supported to attend scheduled health care appointments and arranged their visits to enable these.

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.

People and their relatives told us they were able to contact the registered manager or one of the directors at any time to provide any feedback. One said, “We are able to call and discuss matters as needed.”

The management team spoke to people and staff on a regular basis and in this way monitored outcomes. As there was a small client group this system allowed for communication and monitoring. These contacts were not routinely recorded to support any outcomes.

One staff member said, “We work with the same people and get to know them well.” Another explained that managers were always available to discuss any issue or concern.”One person said, “I have the same staff for each visit. I have 3 regular staff, and I have an hour visit.”

Formalised systems to monitor and improve outcomes had not been established and the management team recognised the need for effective systems in the future especially as the size of the service increases.

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

People were involved in deciding the care and support to be provided. The registered manager confirmed all people currently receiving personal care had capacity to decide what care and support they wanted and when. Staff told us they asked for consent at each visit before providing any support. Staff understood people had capacity to make decisions about the personal care and support they received. One told us, “We don’t provide care unless agreed to.”