Garsewednack Residential 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 requires improvement. 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 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

A new care planning system had been introduced and care plans updated to better reflect people’s needs and preferences. Specific care plans relating to people’s individual health needs had been developed. For example, one person had a care plan relating to their diabetes. Care plans now included guidance for supporting people who were at risk of choking.
 

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.

Some people were at risk associated with poor hydration. Records indicated how much people should be drinking and staff recorded what had been offered and how much people had drunk. Relatives told us their family members always had drinks available. One told us, “I’ve noticed they monitor everything [pronoun] eats and drinks. [Relative’s] food is pureed now and they have thickened drinks. They had plenty of cold drinks when it was hot.”
People had access to a varied and healthy diet. Kitchen staff were aware of people’s dietary needs and preferences. People and relatives were complimentary about the food. We observed people during lunch and saw people enjoying their meal. We heard one person comment to another, “'This is well proper. They know how to make custard here.”

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.

Staff told us communication had improved and they felt they were kept up to date with people’s changing needs. One commented, “The handover is better now. We record what happens in a shift, it’s really helpful. We sit down with the night shift when we start in the morning and have another one at the end of the shift. It was less organised before.”
Professionals also provided positive feedback about their communication with the service. One told us, “The home are now aware of who to refer to if required, ensuring we are all on the same page and to reduce delays to treatment.” Another said, “Communication from the team has been outstanding. Staff are always contactable, responsive to queries, and keep professionals updated appropriately.”
 

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Although some daily activities were organised these were mainly ad hoc and depended on staff having time to spend with people. There was no evidence they had been planned with people and aligned to their interests. There were limited opportunities for gentle exercise such as chair exercises or similar. These types of exercises can help improve mobility and prevent falls. One relative commented, “I don’t think [relative] has done any activities or whether they are encouraged to do so.” People who spent their time in their rooms had fewer opportunities for meaningful activity. Records did not indicate they were protected from the risk of social isolation.
However, people had access to safe outdoor spaces and fresh air. The importance of this was recorded in care plans. One person’s care plan read, ‘[Name] enjoys time in the garden and should be supported and encouraged to do so to stay healthy.” Some one-off activities had been organised and people had enjoyed these. For example, entertainers had visited the home and residents had judged a Bake-Off competition.
 

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 manager had identified gaps in weight records and had introduced new monitoring systems to ensure people were weighed regularly. This meant staff would be able to quickly identify if people were at increased risk.
Some people were at risk due to poor hydration. Fluid intake was monitored and staff had guidance on how and when to escalate concerns. When people had been identified as being at risk of poor skin integrity staff monitored their skin regularly to check for any deterioration. An external professional told us, “I supported staff around pressure prevention and the use of equipment. They had a good understanding of the equipment being used and why it was being used.”

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

Staff demonstrated a good understanding of people’s rights around consent. One described how they, and other staff, had spoken with a person about a potentially unwise choice involving their sleeping arrangements. They told us the person had acted on their advice initially but had then decided they were not comfortable following the advice. The member of staff commented, “They have capacity and it is their choice.”