Background to this inspection
Updated
22 February 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 28 January 2022 and we gave the service 1 days' notice.
Updated
22 February 2022
This inspection took place on 10 May 2018 and was unannounced. This was the first inspection of the service since it was registered in 2017. Gracewell of Bath is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Gracewell of Bath is a purpose built establishment; it provides care and support for up to 62 people. The service provides care over three separate floors depending on their level of need; Poolside (residential), Sulis Way (dementia care) and Globetrotter (nursing). Each floor has its own lounge, dining room and utility kitchen. All bedrooms are single with en-suite toilet facilities. At the time of our inspection, there were 43 people living in the home.
Staff supported people living with dementia; however there was limited evidence of the development of the environment for people with specific needs affected by their condition. We have made a recommendation about the development of the environment to meet the specialised needs of people living with dementia.
There was a registered manager in post at the service. 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.
Medication Administration Records were completed accurately and guidance was in place for people who were prescribed 'as required' medication. People told us they were happy with how their medicines were managed and received this when they needed it.
Risk assessments were detailed and contained sufficient information to guide staff on how to minimise the risk of harm for people who lived at the home.
Fire procedures in the event of an evacuation were clear and regular mock fire drills were completed.
Checks were completed to ensure the environment was free from hazards.
The training records showed staff had received relevant training to ensure they had the skills to support people effectively. Our discussions with staff showed that they had a good knowledge about the people they supported and understood people's individual needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service operated within the principles of the Mental Capacity Act 2005 (MCA). Our review of records showed that processes were in place to assess people's capacity and make decisions in their best interests.
People were supported to maintain good health and well-being. The home had a good relationship with a local GP and had regular dialogue with the local community mental health team. Referrals were made promptly to health professionals such as speech and language team, the dietician and tissue viability nurses.
People told us they enjoyed the food served at the home. Staff knew, and catered to, people's individual dietary needs and preferences. Nutritional risk assessments were completed and diet and fluid charts were in place for those who required them.
We observed kind and compassionate interactions between staff and the people they supported. Staff offered reassurance to people in distress. People told us they liked the staff that supported them. Care plans were personalised and evaluated monthly. We noted that any changes in people's needs were documented and actioned appropriately.
A complaints policy was on display in the home, which contained details for the local authority and Local Government Ombudsman if complainants were not happy to go to the provider. People told us they would not hesitate to raise concerns with the registered manager if they felt they needed to. Complaints were documented and managed in accordance with the registered provider's complaints policy.
Quality assurance systems were effective and measured service provision. Regular audits were completed for different aspects of the service such as medication, care plans and accidents and incidents. Opportunities were provided for people and their relatives to provide feedback on their experience of the care provided and contribute to improving the service delivery. This included quality assurance surveys, a suggestion box, residents, and relatives meetings.
The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with statutory requirements.