This inspection took place on 21 and 26 June 2018. It was an unannounced visit to the service.

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. This means the service is subject to one inspection visit however the report is published on our website twice, under each provider.

This was the first inspection since the service registered to provide accommodation for people who require nursing or personal care. The home is registered to provide care and support for up to 72 people. At the time of our inspection 38 people were living at the home. The home accommodated younger and older adults some of whom were living with dementia.

Gracewell of High Wycombe 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.

The service had a registered manager in post. 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.

The feedback we received from relatives was overwhelmingly positive. Especially for the support they had received when their family member moved into the home. Comments included “Thanks for the lovely welcome that (Name of registered manager) and the team gave him and all of us as a family. They honestly couldn’t have been nicer and more caring with him and this makes (Name of husband) and I very relieved,” and “I remember you said to me when dad first arrived that we could treat Gracewell as our home and that certainly turned out to be true. We felt welcomed whenever we visited.” Another relative had told the service, “Thank you all for helping us on ‘move in day’, your kindness and friendliness was much appreciated.”

The service provided excellent care to people who were approaching the end of life. This was extended to relatives both at the time of death and after. Feedback from relatives to the service confirmed how much they felt looked after by the care home staff and how they had been supported to celebrate the life of their relative. Comments included “The nursing and care staff making dad as comfortable as possible… thank you so very much for not just being excellent but perfect in every aspect of his care,” “I cannot thank you and your staff enough for the care given to my father at the end of his life,” We wanted to express our heartfelt thanks for looking after (Name of person) and us, so wonderfully. We take great comfort from knowing that (Name of person) was with you in his final weeks, because we really could not have wished for better care. Every single member of staff was amazing.” Another relative had commented “Your compassion, understanding and empathy gave all great comfort, peace and dignity during a difficult time. It has been a privilege and honour to meet you and to know that genuine nursing care and compassion with respects still exists.”

We observed people received a positive experience from living at the home. We saw people benefited from positive staff engagement. Staff understood people’s needs and when people displayed distressed behaviour staff were able to quickly and professionally defuse the situation.

People were routinely and consistently treated with dignity and respect. People had developed meaningful relationships with each other. We observed and relatives confirmed that they had also got to know other residents and relatives. We observed the staff encouraged a friendly, warm atmosphere. We received lots of feedback about how the families of residents felt welcome to visit at any time