Queensgate Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The previous rating for this key question under the old provider was good. At this assessment we found the rating has deteriorated to requires improvement. People told us they were happy with their care. However, the lack of staff training in people’s specific conditions meant we could not be assured they were always supported in a person-centred way. It was clear people and staff had good relationships. However, most of the engagement between staff and people was provided during support needs. Staff raised their concerns they did not have time or resources to always support people with non-care related activities. People received input from other health professionals. Reviews were seen within care files with social workers, mental health teams and GP’s. However, records and feedback from partner organisations confirmed that information following a review was not consistently updated to ensure people received the best possible service. Information was recorded to support people’s individual communications needs. However, we recommend the provider reviews the Accessible Information Standard (AIS). The AIS is a rule for health and social care services that says they have to communicate with people in a way they can understand.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's relatives told us they were involved in the initial assessment and development of their loved one's care plans. However, we could not be assured that people, and their relatives remained central to ongoing reviews to keep information up to date and relevant. Although some people told us they were happy with their care, the lack of staff training in people's specific conditions meant we could not be assured they were always supported in an individual and person-centred way.

Although staff were passionate about delivering person centred care, they told us they weren't always able to do this. For example, there was a lack of meaningful activities for people to enjoy, and some staff told us they did not always have time to spend supporting people with everyday non-care activities.

During our inspection we saw staff offered people choices and involved them in daily decision making. Interactions we observed between people and staff were positive. It was clear people and staff had good relationships. However, most of the staff engagement with people was observed to be carried out during the supporting of care needs.

People and their relatives told us that people were referred to health professionals when required. Relatives told us peoples care provision was communicated to them where appropriate to do so.

The manager told us they used 'patient passports' to ensure continuity of care when people were transitioned to hospital.

The service worked in partnership with funding authorities to review people’s care. Health professionals told us, "They follow our recommendations, they are a lot better." However, they told us records could be improved as it was at times a struggle to get what they needed from the paperwork.

Records relating to other professional involvement were not always clear. For example, records stated people required tests, or tests had not been completed and would need to be re done, but there was no further follow up to evidence these had been completed as required.

Information at the service would benefit from being more accessible for people following the consistent use of different formats people could understand. Some information was in accessible formats, for example the annual satisfaction surveys, but the same process was not applied to the outcomes and any actions for people's benefit and undertstanding.

The nominated individual was aware of the Accessible Information Standard (AIS) and told us they would review policy and processes to ensure people received information in the appropriate formats should they require this. Staff told us they offered verbal choices to people and understood people’s body language when they could not communicate verbally. Some staff told us they had picture cards to aid some communication.

From 1 August 2016 onwards, all organisations that provide NHS care and/or publicly-funded adult social care are legally required to follow the Accessible Information Standard (AIS). The Standard sets out a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment or sensory loss. The provider had an AIS policy and people’s communication needs were recorded in their care plans, but these were not in sufficient detail to ensure they were always supported to understand and respond to information.

Overall people and their relatives told us they felt listened to and that they could raise concerns should they need to. One person told us, “We make our contribution to ideas for the home, for example menu items. They appear to listen and implement them.” People and their relatives told us they were involved in the development of their care plans. However, some relatives told us they had not always been involved in reviews.

Not all staff felt comfortable to raise their concerns and at times felt like they weren’t listened to. Staff were concerned that communication was inconsistent meaning they did not always receive important information required to effectively fulfil their role. Staff told us if people were unhappy they would listen to them and ensured they helped where they could. They told us they raised anything that needed escalating to seniors on duty.

The provider had policies and procedures for the management of complaints. However, some complaints did not appear to have been dealt with formally and people had not always been given formal responses under required duty of candour. Feedback was sought from people, their relatives and staff in satisfaction surveys, this was then evaluated. However, no further action was recorded to demonstrate resulting actions planned or taken.

People told us they lived in an accessible internal environment. However, improvements were needed to support people to access the outside areas.

Staff told us they ensured people who were cared for in bed, or in their rooms were supported to mitigate the risks associated with social isolation. They told us the activity staff would spend time with them in their rooms and staff would check on them regularly, so they were not left on their own.

Professionals told us staff contacted them for advice to meet and respond to people's needs when required

Provision to record people's needs was available in their care plans. External referrals were made when required. The provider had an on-call system to ensure support was available in the event of an emergency or any unplanned care.

Most people felt they were listened to with their choices and decisions respected. We could not see any evidence people had been given the opportunity to discuss any diverse needs or how any outcomes people wanted were supported or monitored.

Staff told us there was nobody using the service at present with any specific religious or cultural needs. They told us they understood the importance of respecting people’s beliefs and that they would respect people as individuals. Staff told us they had not observed any discriminatory behaviours.

Peoples care plans did not always include information which recorded any diverse needs to ensure staff could respond accordingly. For example, people's sexuality and religion. Not all staff had received training in equality and diversity.

People had not always been offered the opportunity to plan for their future. One relative told us, “The staff have not discussed any future planning such as end-of-life care.”

The Nominated Individual told us they previously recorded end of life care plans which supported people's wishes and preferences. They told us they would be re introducing these plans. Some staff told us they had not had end of life training and felt this was needed. One staff told us, “If we knew how to care for the residents at the end of their life, it would improve their care. It should be mandatory training for us.”

When decisions had been made regarding people’s care, respect forms were in place. However, people had not been given the opportunity to develop their care plans; to make and record informed decisions about their future, including at the end of their life.