Gracefield Nursing Home and Residential Care Home provides accommodation and personal care for up to 17 older people, some of whom may live with dementia or have a learning disability. The home is an adapted and extended single storey residential building and is located on the outskirts of the rural village of Dry Drayton near Cambridge.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Staff knew how to respond to possible abuse and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were stored and administered safely.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People received a choice of meals, which they liked, and staff supported them to eat and drink enough. They were referred to health care professionals as needed and staff followed the advice professionals gave them.

Staff were caring and kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records guided staff in how to do this. There was a variety of activities for people to do and take part in during the day, and people had enough social stimulation. Complaints were investigated and responded to and people knew who to speak with if they had concerns.

Staff worked well together and felt supported by the management team. The monitoring process looked at systems throughout the home, identified issues and staff took the appropriate action to resolve these.

Further information is in the detailed findings below

Gracefield Nursing Home and Residential Care Home provides accommodation for up to 17 people who require personal care or nursing care. The home mainly provides support for people who are living with dementia, people with a learning disability and people with mental health needs. The home is a single storey building and has 13 single bedrooms and two double rooms. There were 17 people living at the home at the time of our inspection.

There was a registered manager in post at the time of this inspection. 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.

We last inspected Gracefield Nursing Home and Residential Care Home in October 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

Although people had mental capacity assessments completed, information about their best interest decisions was not well documented and needed to be improved. Deprivation of Liberty Safeguards guidance had been followed and submitted applications sent to the appropriate agencies so that people were not deprived unlawfully.

People’s health and care needs were assessed and reviewed so that staff knew how to care for and support people in the home. People had access to a wide variety of health professionals who were requested appropriately and who provided information to maintain people’s health and wellbeing.

The risk of abuse for people was reduced because staff knew how to recognise and report abuse. People were supported to be as safe as possible and risk assessments had been written to give staff the information they needed.

Staff received an induction and were supported in their roles through regular supervision, annual appraisals and training to ensure they understood their roles and responsibilities.

People had a choice of meals, snacks and drinks, which they told us they enjoyed. People had been included in planning menus and their feedback about the meals in the home had been listened to and acted on.

People were able to see their friends and families when they wanted. There were no restrictions on when people could visit the home.

People and their relatives were confident raising any concerns or complaints with the management and that action would be taken. Information was available so that people could be provided with independent advocates.

Staff supported and encouraged people with activities that they enjoyed.

People in the home and their relatives were very happy with the staff and management. People were involved in meetings, and action was taken where requests or comments had been raised.

The provider had an effective quality assurance system in place which it used to help drive improvements to people’s care and the home they lived in.

There were procedures in place for people, or their representatives acting on their behalf, to give consent regarding their support, care and treatment. People had access to advocacy services, should they choose to be represented by an independent agency.

We saw that people were provided with support and care to meet their individual care, including nursing care, needs. People’s level of independence was maintained and promoted and they were provided with individual recreational activities to maintain their sense of wellbeing. People’s health was maintained because they were supported to access a range of health care services.

People’s dietary needs and choices were catered for. People were offered a choice of what they would like to eat and drink and were supported with maintaining their hydration and nutritional needs.

The home was well-maintained and safe for people to live, work and visit. Work was in progress to improve the standard and quality of the current premises. A visitor told us that they felt the place to be, “Homely.”

There were maintenance and checking systems in place to ensure that equipment was safe for people to use.

A complaints procedure was in place, which people’s representatives had been made aware of. However, people were very satisfied with the standard and quality of the support, care and treatment and said that they had no cause to make a complaint.

We found Gracefield Nursing home to be clean and comfortable. The outside space was well maintained. One person told us, "I don't do too badly here". Another said, "I like my room".

We saw that improvements had been made to the premises. A new kitchen had been installed, together with a new bathroom and toilet. Flooring had been replaced in a number of the rooms. Staff told us, "The new bathrooms and kitchen have made a big difference".

People's care plans were reviewed regularly to ensure that changes were identified in a timely way. A relative told us, "I can't fault the care. Staff keep me informed on every aspect".

We saw that a wide range of activities were offered to people. One person told us, "Sometimes we have a drink and dinner at the pub". We saw people engaged with the reminiscence activity on the day of our visit.

We spoke with four people who told us that they felt well supported and that the staff were kind and helpful. Other people did not share their views about the care and support provided. Four people we spoke with indicated that the accommodation and private bedroom space meet their individual preferences and needs