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Gracewell of High Wycombe Good

This care home is run by two companies: Gracewell Healthcare 3 Limited and Gracewell Healthcare Limited. These two companies have a dual registration and are jointly responsible for the services at the home.


Inspection carried out on 22 December 2020

During an inspection looking at part of the service

Gracewell of High Wycombe is a nursing home which can accommodate up to 72 people. Fifty three people were using the service at the time of this visit. People were accommodated in single, en-suite bedrooms.

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. This means the service is subject to one inspection visit, however, the report is published on our website twice, under each provider.

We found the following examples of good practice.

Visitors were restricted during the current outbreak of Covid-19. Lateral flow tests were carried out before visitors could access the building. A separate area had been created to carry out these tests and for the visitor to wait in. Full personal protective equipment (PPE) was then provided to keep the person and those living and working at the service safe. Families were able to visit to see people receiving end of life care, using these processes.

Staff were tested before they came on duty, using lateral flow tests. They also received regular weekly testing. Anyone who tested positive followed isolation procedures and remained off work until there was no risk of transmission. Agency workers had been used to help support the home where several staff needed to be off work. These workers were block-booked and only worked at this service, to reduce the risk of transmission from home to home.

The risk of transmission around the building by staff had been assessed and reduced. For example, staff rest rooms had been created in the part of the home they worked in, to reduce movement from floor to floor. Staff had completed training on infection control practices. The risks of potential exposure to the virus had been assessed for all staff, taking into account health conditions and high risks associated with people from black, Asian and other ethnic minority backgrounds.

The service had good supplies of PPE. This was readily available at the entrance and around the building. There were clearly marked areas for donning and doffing PPE and clinical waste bins were provided for disposal. Hand sanitiser was available throughout the building.

People were tested prior to admission to the home and isolated in their room. Managers had been able to use vacant rooms to create isolation areas for people who had tested positive. Risk of transmission had been reduced through numerous practices, such as removal of table cloths and using disposable crockery and cutlery for people who were isolating. Regular testing was carried out for people who used the service.

The premises were kept in a clean and hygienic condition throughout by a team of housekeeping staff. Fumigation had been undertaken by external contractors the day before this visit.

The home had liaised with appropriate external bodies for advice and guidance, such as Public Health England. Managers were also undertaking a root cause analysis, to help prevent further occurrence. A business contingency plan was in place, to reduce the effects of potential disruption to people’s care. There were policies and procedures to provide guidance for staff on safe working practices during the pandemic. Auditing and observation of care practice took place to ensure these were adhered to.

Inspection carried out on 21 June 2018

During a routine inspection

This inspection took place on 21 and 26 June 2018. It was an unannounced visit to the service.

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. This means the service is subject to one inspection visit however the report is published on our website twice, under each provider.

This was the first inspection since the service registered to provide accommodation for people who require nursing or personal care. The home is registered to provide care and support for up to 72 people. At the time of our inspection 38 people were living at the home. The home accommodated younger and older adults some of whom were living with dementia.

Gracewell of High Wycombe is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The feedback we received from relatives was overwhelmingly positive. Especially for the support they had received when their family member moved into the home. Comments included “Thanks for the lovely welcome that (Name of registered manager) and the team gave him and all of us as a family. They honestly couldn’t have been nicer and more caring with him and this makes (Name of husband) and I very relieved,” and “I remember you said to me when dad first arrived that we could treat Gracewell as our home and that certainly turned out to be true. We felt welcomed whenever we visited.” Another relative had told the service, “Thank you all for helping us on ‘move in day’, your kindness and friendliness was much appreciated.”

The service provided excellent care to people who were approaching the end of life. This was extended to relatives both at the time of death and after. Feedback from relatives to the service confirmed how much they felt looked after by the care home staff and how they had been supported to celebrate the life of their relative. Comments included “The nursing and care staff making dad as comfortable as possible… thank you so very much for not just being excellent but perfect in every aspect of his care,” “I cannot thank you and your staff enough for the care given to my father at the end of his life,” We wanted to express our heartfelt thanks for looking after (Name of person) and us, so wonderfully. We take great comfort from knowing that (Name of person) was with you in his final weeks, because we really could not have wished for better care. Every single member of staff was amazing.” Another relative had commented “Your compassion, understanding and empathy gave all great comfort, peace and dignity during a difficult time. It has been a privilege and honour to meet you and to know that genuine nursing care and compassion with respects still exists.”

We observed people received a positive experience from living at the home. We saw people benefited from positive staff engagement. Staff understood people’s needs and when people displayed distressed behaviour staff were able to quickly and professionally defuse the situation.

People were routinely and consistently treated with dignity and respect. People had developed meaningful relationships with each other. We observed and relatives confirmed that they had also got to know other residents and relatives. We observed the staff encouraged a friendly, warm atmosphere. We received lots of feedback about how the families of residents felt welcome to visit at any time