Gainsborough Care 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 good. At this assessment the rating has remained 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.

The registered manager visited prospective new residents of the service in their homes, other residential settings or hospitals to assess them prior to admission. Information about people’s health and wellbeing, their mobility support needs, personal care needs, medicines they were taking, and interests were among a wide range of information gathered in order to ascertain if the service was appropriate and able to meet their needs.

Information was sought from the person, their relatives and health and social care professionals to provide a clear representation of the person to ensure information was unbiased and not just from a single viewpoint.

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.
The provider ensured they weighed people at least monthly and in line with their individual needs. Where the risk of malnutrition was identified, measures were in place to support calorie intake. For example, 1 person had a detailed care plan to describe how their calorie intake could be improved. Actions included the use of supplementary drinks, additional snacks, fortifying meals and drinks and offering second helpings of meals.
The provider also ensured food and fluids were the correct texture for people in line with their assessed needs. People were referred to the speech and language therapist (SaLT) should they experience difficulties with swallowing or cough during mealtimes. Whilst waiting for an assessment, the provider would, to minimise risks, temporarily change the person’s diet to a transitional texture until a permanent diet was recommended by SaLT. Pureed and other modified texture meals were well presented and the chef had access to specialist recipes for textured foods. The chef provided meals for specific diets, including for vegetarians and medical conditions such as colitis which affect the types of food people can eat. They also ensured people could choose their meals, for example, cooked breakfasts were available every day.

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 provider worked with health and social care professionals sharing information, with permission, to ensure people received the right care and treatment.
Healthcare professionals added records of their interactions in people’s eCare notes. Details of appointments and mainly video calls were recorded along with any guidance and changes made to the persons care by the practitioner.
The provider ensured people were admitted to hospital with their current care plan and medicines to ensure continuity of care was achieved.

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.

The local GPs visited the service weekly and when needed calls were made if people were unwell. Other healthcare professionals such as SaLT and district nurses attended the service as required.

Activities took place at Gainsborough and were suitable for groups of people such as having singers attend to perform and movie afternoons. Another activity with staff was nail care. Most other activities were self-directed such as doing jigsaws, word searches, reading or drawing.

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 provider had a range of checks it completed to ensure peoples care was continually monitored and improved. The registered manager completed audits of care, for example reviewing accidents and incidents to identify themes and patterns to reduce future risks. They also reviewed people’s weights to ensure the correct information was available to care staff and the catering team, so people received appropriate support.

The information gained from audits of care also informed healthcare professionals should people require such input.

Reviews of care plans, involving people and relatives when possible ensured care delivery was appropriate to peoples changing needs.

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

On a day to day basis, staff asked people for consent before providing care or support. Staff understood that if a person lacked capacity to make some decisions, they could make other decisions, for example about what to wear or what to eat.
The provider understood their role in supporting people and their relatives with decision making. One person’s care record read, “Staff should contact [person’s relatives], if a decision about [person] needs to be made so they can be included in this process. Although [person] lacks capacity, they should still be involved in all decisions made in ‘their’ best interests. Any decisions made in their best interest should be the least restrictive as possible. [Person’s relatives] have Power of Attorney for Health and Welfare and Property and Affairs (PoA) and therefore are legally able to support [person] with all aspects of decision making where they may have difficulty”.
On admission to Gainsborough, Mental Capacity Act 2005 (MCA) assessments were completed to ascertain people’s capacity. Once completed, these were reviewed each month as people’s capacity could fluctuate. When necessary, the provider applied for Deprivation of Liberties Safeguarding (DoLS) authorisations to cover their care at Gainsborough and other aspects of their life such as use of sedating medicines or to prevent them leaving the premises alone. There was only one condition to the authorised DoLS which was the responsibility of the persons social worker. Reapplications to have authorisations continued were made in a timely way.
Relatives told us, “We do hold PoA and have been involved with and contributed to decisions. We are happy that consent is sought. We have recently completed a DoLS”. A second relative said, “Myself and my two brothers hold PoA for my [person] and have always been consulted when appropriate to do so, as [person] does not have mental capacity due to their Alzheimer’s”.
We reviewed records of consent to care for 6 people, some who had capacity, some who lacked capacity. None of the forms had been signed by people, they had all been signed on behalf of people under the following statement, “Where the person has full capacity but is unable to sign due to reasons of health, frailty, poor dexterity etc. I confirm the assessment, and care and support plan has been read to them in a manner they understand, and they have verbally consented to the plan of care.” In addition, the form template had numerous spelling and contextual errors that should have been noted before use.