Goatacre Manor Care Centre

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.

Leaders told us there was a detailed admission process to ensure a person’s needs could be met effectively at the service. This included an initial face to face assessment and discussions with relatives and involved health care professionals if appropriate. They said people were encouraged to visit the service to meet others and gain an insight into care delivery.

Records showed people’s needs were regularly assessed and reviewed. Relatives were encouraged to be part of care plan reviews if the person wanted this. One staff member said, “Instead of resident of the day, we do resident of the week, which means we have more time to do a full and proper review and include the relatives.”

Staff told us they were informed about new people moving to the service and were given an overview of their needs.

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.

Nationally recognised tools were used to assess and monitor people’s needs and any risks they faced. This included a Malnutrition Universal Screening Tool (MUST) which is used to identify adults who are malnourished, undernourished or obese.

There were specific staff with the responsibility of ensuring people had enough to eat and drink. Throughout the inspection, we observed staff regularly encouraging and prompting people’s intake. This included regular drinks and snacks between meals.

Records demonstrated support and advice was sought from external health professionals when required. Any outcomes of these discussions were documented in people’s care plans.

However, whilst care planning included photographs of any wounds, measuring tools were not included. The use of measuring tools is good practice, as it ensures accuracy as well demonstrating improvement or deterioration of the wound. Leaders told us they would ensure the tools were used moving forward.

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 they could access health care when needed. One person told us “There is always a qualified nurse on duty. You see them 2 or 3 times a day. They arrange for the doctor to come.” A relative told us, “They’ll get [a GP] for her or they’ll go on the list. We got her a chiropodist for their toenails, which was no problem at all.”

Staff told us communication within the service was good. They said there were daily meetings, with a representative from each department attending. This enabled key messages to be shared and then escalated to staff within the wider teams. Records demonstrated there were other staff meetings and group supervision. Staff told us the meetings enabled them to keep up to date with the daily running of the service.

Staff worked closely with other health and social care professionals to meet people’s needs. For example, records showed people had been reviewed when required by speech and language therapy (SALT), the tissue viability nurse and the GP. A health professional told us “The nurses are brilliant; I trust their judgement. They know their residents. They are very good knowing when clinically someone is deteriorating and they flag it up really quickly. They know what they're looking for.”

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.

Leaders and staff told us people were supported to be as healthy as possible. This included encouraging people to maintain their mobility, keeping as active as possible and eating a well-balanced diet. People’s weight was regularly monitored, and any weight loss was kept under review and raised with the GP. One member of the catering team told us they were kept informed of dietary needs, including allergies and weight loss. They said food was fortified as needed with butter or cream, which promoted weight gain through additional calories.

People told us they had a varied diet, and regular drinks to keep healthy. One person told us they joined the exercise class to help their mobility. Another person said they liked to walk in the garden.

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.

There were regular reviews of people’s care, and relatives and external health professionals were involved as required.

Leaders described a range of positive outcomes people had experienced. This included improvement in health and wellbeing and inclusion through social activities and community involvement.

Staff were very aware of people’s needs, and how to meet them. This included how to de-escalate anxiety or distress a person was experiencing. However, this was not documented, and inconsistencies with fluid intake and skin integrity monitoring records did not always evidence the support staff delivered. We discussed this with leaders who were receptive and proactive with making improvements to care planning and associated care records.

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

People were offered choice and asked to give consent before any care intervention. This included whether they would like a clothes protector whilst eating their meal or a wipe to clean their hands. Staff told us they always encouraged decision making. They gave examples of asking a person if they could take their plate, or if they needed assistance with a wash. One staff member asked a person if they could sit next to them and help them to eat.

Records demonstrated staff had completed training in the Mental Capacity Act 2005 and there was a policy for reference as required.

People’s capacity had been assessed in line with legislation. However, records of decision making, did not always include if any, less restrictive options had been considered. Leaders told us they would address this within all capacity assessments moving forward.