Archived: Gracewell of Newbury

Updated 28 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gracewell of Newbury is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information the registered manager sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed the notifications received from the provider, since the last inspection. The law requires providers to send us notifications about certain events that happen during the running of a service. We contacted local authority teams engaged with the service, including clinical commissioning groups, continuing health care groups, the local fire authority and environmental health for information to aid the planning of our inspection.

During the inspection

We spoke with 14 people who used the service and 10 relatives. We also spoke with the registered manager, the provider’s director of operations, the two clinical nurse managers, three nurses, three senior care assistants, six care assistants, the activity coordinator, the chef, deputy chef, kitchen assistant, the housekeeper and three members of the housekeeping team. We also spoke with two agency nurses and six visiting health and social care professionals.

We observed medicines being administered and the support people received in communal areas, including the preparation and consumption of meals.

We reviewed the service electronic care records, including seven people’s care plans and medicine administration records (MAR), 10 people’s clinical alerts, relating to skin care, falls management, nutrition and behaviour and the progress notes of 11 people identified to be high priority. Clinical alerts ensured urgent treatment had to be completed before the alert could be closed. We looked at 10 staff recruitment and training files, together with the provider’s training and supervision schedules. We also examined other documents relating to the management of the service, including policies, procedures, quality assurance audits and satisfaction surveys.

After the inspection

We spoke with two community health and social care professionals.

Updated 28 August 2019

About the service

Gracewell of Newbury 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.

This care home is run by two providers; namely, Gracewell Healthcare Limited and Gracewell Healthcare 3 Limited. These two providers have a dual registration and are jointly responsible for the services at the home. This report is in relation to Gracewell Healthcare Limited. A separate report has been produced for Gracewell Healthcare 3 Limited.

Gracewell of Newbury accommodates up to 68 people in one building over three floors. The first floor was the ‘Memory Care’ community, which had been designed as a living space suitable for people living with dementia. There were 64 people living in the home at the time of inspection. People living at the service were older people, some of whom were living with dementia.

People's experience of using this service

The service provided exceptionally responsive, person-centred support to people which consistently achieved outstanding outcomes for people. Staff provided excellent consistency and continuity of care which had a major impact on people’s quality of life.

Staff were particularly skilled at involving people and their family, together with health and social care professionals in their care and support plans, so that they felt consulted, empowered, listened to and valued.

Staff consistently went the extra mile to find out what people have done in the past to enable people to carry out person-centred activities which enriched the quality of their lives. People were supported to maintain relationships that mattered to them which protected them from the risk of social isolation and loneliness.

The registered manager used concerns to improve the service. For example, a Hydration Project initiated within the service had significantly reduced the number of falls, infections and weight loss experienced by people living in the home.

The service worked closely with healthcare professionals and provided outstanding end of life care, which ensured people experienced a comfortable, dignified and pain-free death.

People were supported by a stable core staff group who were kind, caring and inspired by the registered manager to deliver high quality, personalised care.

People were protected from discrimination, neglect, avoidable harm, and abuse by staff. Risks to people's safety had been identified and assessed. Staff followed people’s risk management plans to keep them safe. People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed. People’s medicines management plans were reviewed regularly to ensure continued administration was still required to meet their needs.

High standards of cleanliness and hygiene were maintained throughout the home, which reduced the risk of infection. Staff followed the required standards of food safety and hygiene, when preparing, serving and handling food.

Staff felt valued and respected by the management team, and consistently demonstrated high levels of morale.Staff had the required skills to meet people’s needs effectively, which led to good outcomes for people’s care and support and promoted their quality of life.

People’s care plans were comprehensive, providing staff with the required information about their needs and how to meet them.

The registered manager had worked effectively with local organisations, health and social care professionals and multi-disciplinary teams and was often the driving force to improve outcomes for people, through joined up care provision.

Rating at the last inspection

At the last inspection the service was rated Good (published 26 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We did not identify any concerns at this inspection. We will therefore aim to re-inspect this service within the published time scale for services rated good. We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk