Wombwell Hall

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 findings from this assessment indicate a Requires Improvement rating under the Responsive domain. We found one breach of the legal regulation in relation to Person-centred Care. People did not consistently receive personalised care to meet their needs. There were some systems in place to seek some people’s views. Action was not always taken when concerns or suggestions were raised. The activities available to people were not always accessible and had not always been adapted to meet people’s needs. Staff were passionate about providing good quality care at the end of people’s lives. They worked alongside external healthcare professionals to ensure people received a comfortable, dignified death.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives gave mixed feedback their experience of person-centred care. For example, some felt they had not been involved in the development and review of their care. Whereas some people felt supported to understand their condition and the support they needed. Some people felt their care was not always personalised. For example, a person said, “The nurses shave me and do quite a good job. Occasionally they forget and I have to ask them.” Records we reviewed such as care plans did not consistently reflect people experienced person-centred care. Some care plans viewed at the service had the wrong name to the person whose care plan it was. Care plans were not full enough with relevant detail. Care plans were not always updated with people’s current and changed care needs. The staff completing them often relied on the systems standard sentences and did not personalise the information. This meant staff were not guided to provide person-centred care.

Staff told us they knew people well and knew how to meet their needs. One member of staff said, “We have handovers. It helps have an insight into how people are getting on and feeling and we know how to tailor their care accordingly.”

Activities that were available to people were not always adapted to meet people’s needs. For example, people living with dementia had not always been accounted for.

People told us they felt the staff knew them well and understood their needs and that external healthcare professionals would be contacted if required to provide appropriate care provisions for them. For example, one person said, “I got a chest infection and got panicky. They got an ambulance for me, and I was taken into hospital.” Some people’s protected characteristics were supported through the integration of compatible staff. For example, there were staff who spoke the same language as a person whose first language was not English.

Staff felt they worked well with external healthcare professionals and had a good working relationship with the professionals who visited the service on a regular basis. One member of staff said, “We have the specialist community nursing team visit every Thursday to see the residents. We contact the GP if a person needs it. The GP will do video consultation.”

Partners shared some examples of when joined up working had resulted in positive outcomes for people. There was an example of a joined-up way of working when following a new admission of a person their health had declined and the staff contacted the healthcare professional for advice and support, which had enabled the person to be seen the same day which had improved the person’s health. However, we also received some negative examples of where there had not been joined up working such as when communication with other professionals had not been timely.

Some people’s care records contained very little information to guide and inform staff on how to meet the person’s needs. Care records did not evidence a joined-up way of working between staff at the service and external healthcare professionals. One person that had used a step-down bed after being discharged from hospital whilst awaiting to go back home had a very basic care plan which had not recorded the concerns that were in the discharge notes from hospital. Therefore, staff could have placed the person at risk of potential harm by not following the most relevant and up to date information.

People did not give us any specific feedback regarding how information had been provided to them. However, we found mixed evidence about how accessible and effective the services communication was with the people they supported. For example, we found contradictory examples of how people with alternate communication needs were supported.

Staff did not share any feedback about ways in which they provided information to people living at Wombwell Hall in a way that people found accessible. Staff did comment that they speak to people politely and listen to what they have to say.

Information was not tailored to meet people’s individual needs. For example, the menu for the day was in a written format displayed in a folder. This was not accessible to meet people’s individual needs, nor was it visually displayed for everyone to access. The provider information return from November 2023 stated that the current electronic care plan system was able to identify and record how people would like to receive their communication such as, by letter, braille or via audio. However, this had not been completed for people using the service.

People’s views were mixed regarding whether they had been asked for their views in relation to the care they received. Comments included, “They absolutely never ask me if I’m happy with things and the care I get” and “They never ask me if I’m happy with my care.” Other examples were given of when staff had taken notice of what people had said and made changes. One person said, “At one time, they were putting me to bed before I wanted to go, so I told them, and it has been better since.” Another person told us they had asked staff not to open their bedroom door between the hours of 10pm and 6am, as this disturbed them. This had been actioned by the night staff team.

Staff told us they sought feedback from people using the service a regular basis. One member of staff said, “We do reviews with residents and their relatives, and we ask them for their feedback. We implement suggestions relatives and residents make. Some residents want to stay up late, and some want to go to bed early. We listen to them and respect their wishes.” The registered manager told us that systems were in place to record formal and informal complaints or concerns that were raised via the electronic care plan system they used.

People were given the opportunity to raise any concerns or to make suggestions at regular ‘residents meetings’. However, action was not always taken because of people’s feedback. For example, a person had requested being offered a different drink in the evening on two consecutive meetings where this had not been actioned. Complaints were not always managed in line with the providers procedures. We found that a recent complaint had not been addressed in line with the provider’s procedure. The registered manager had not sent a formal acknowledgement in line with the provider’s procedure. We raised this with the Registered Manager who addressed this during our assessment. We found that up to date records had not been maintained for verbal or informal complaints made about the service. The registered manager told us they addressed little ‘niggles’ immediately.

People did not give us any specific feedback in relation to the promotion of their human rights or removing barriers to enable access to care and treatment.

Staff told us they ensured the environment was safe and accommodated any adjustments to the physical environment to meet people’s needs. For example, staff told us they ensured the corridors were clear and clutter free for people using mobility aids. Staff told us people were supported to access external healthcare professionals as required on a regular basis.

Partners feedback was positive about Wombwell Hall providing equal opportunities to access different services. One professional said, ‘We feel overall that the home gives all residents good access to our service provision.’ Another professional said, all referrals they had made to the service had been treated equally.

The processes in place at Wombwell Hall did not always maximise opportunity for people to have equity in access in all areas of their care. For example, we found that where people were deemed to lack capacity appropriate input from relevant others had not always been sought to support best interest decision for people. This meant people’s right were not always protected. Another example can be seen where people’s first language was not English, and use of an interpreter or fluent family members was not always utilised when making decisions or changes to people’s care.

Some people and their relatives told us they did not feel involved in people’s care plans to help shape people’s experience or outcomes. A relative said, “They never ask us if we are happy with [loved one’s] care. Some other relatives shared similar feedback.”

Staff felt they provided people with equity in relation to their experiences of care within the service. Staff training supported this. Staff gave an example of supporting and respecting people’s differences. A staff member said, “Some cultures don’t like male carers, making sure only female carers attend to their personal care.” Staff also gave an example of providing Vegetarian food.

The processes in place at Wombwell Hall did not always support people to have equity in experience and outcomes. For example, the issues we found with people’s mental capacity assessment which had not been completed in line with the principles of the mental capacity act meant people’s rights were not protected to ensure they had equity in their experiences and outcomes. There were mechanisms in place to seek feedback from some people who were able to, however, people’s feedback was not consistently acted on. For example, In April 2024 a person had requested for photographs of meal to be included in the menu however, at the time of this assessment this had not been completed. Pictorial menus are a beneficial way of supporting people to make informed choices they may not have been able to otherwise.

People did not give us any specific feedback regarding care at the end of their life. However, people had been supported by their loved ones and healthcare professionals to implement a DNACPR (do not attempt cardiopulmonary resuscitation) and a ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) form. This is a process that creates a personalised recommendation for clinical care in emergency situations when the person is not able to express their own wishes. A relative told us they were pleased that their loved one was able to stay living at Wombwell Hall when their health had deteriorated. Staff had received cards from a relative when their loved one had passed away, thanking them for the care and support they had shown. The GP surgery stated, ‘The service ensures better outcomes for people for example, contacting the palliative team when a person requires end-of-life support to ensure they are not in distress or pain. Additional support has also been giving to the family members of the people receiving care at the end of their life.’

Staff spoke positively about supporting people at the end of their lives and ensuring people received a comfortable dignified death. Some staff told us they had a passion for palliative care and had previous experience in this. A unit manager spoke about the additional external counselling support they had sourced for a family member when their loved one had passed away. They also said, “We are able to build very good bonds with people and families.” Another member of staff told us how they liaised and were supported by the local hospice team when they were supporting a person at the end of their life.

There were inconsistencies within people’s care records regarding their future and the end of life care they wanted to receive. Some people’s care records remained blank for this section whereas other people had been supported to record their own wishes. For example, one person’s care plan stated, ‘At the end of my life, I would like to remain at Wombwell Hall care home.’ Details such as what matters to the person, the person’s favourite music, favourite flowers and colours had not been recorded consistently within the person’s care records.