Barnet Grange 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

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

There were times when people did not experience a person centred care experience. For instance, in relation to making some choices with their care needs and preferences, for example, food/beverages, and needing to wait for staff to support them. The lack of availability of enough equipment meant some people needed to wait to use the bathroom. Managers were aware of this issue, but they had not formulated a plan to address this in the short term and considered the impact on people. Some people felt some staff, but not all, were rude to them and did not treat them as an adult. Alternatively, staff did spend time and check people were ok and happy. Staff stopped their tasks to support people and have a quick chat with them. Time was given to people at mealtimes to support them to eat and make the experience a social one. Staff also tried to involve people in the entertainment provided. However, improvements were needed by management to identify and address these negative aspects of people’s care and provide a consistent person centred care experience.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People were supported to access health care options in the community. Staff liaised with health professionals and people’s private health resources. Relatives spoke favourably of the manager of the nursing staff. They felt confident in this member of the management team to co-ordinate health services and advocate for their relatives.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People had access to their care assessments and care plans, most said they were not interested in this information but said these documents were explained to them. People (who had mental capacity to do so) and people’s relatives also knew how to complain.

The provider had systems in place for people to share their feedback and make complaints. But people were not always involved in some decisions about their care.

For those people who were able to share feedback there was a regular attended meeting to share feedback and raise issues. Action was being taken on the matters raised. Staff made efforts to involve people living with dementia with some decisions about their daily care. However, further work was needed to involve people from the onset when they elected to make decisions about their care which were at odds with the professional’s advice. Equally when some people were living with dementia, they were not always being involved in decisions being made on their behalf and in what staff thought were in, ‘their best interests.’

The provider made sure that people could access the care, support and treatment when they needed it.

People were supported by staff to access health care options. Staff reacted quickly in Copperfield when 2 people needed health input, and the nursing manager had established good relationships with the GP practice and community health teams to promote people’s access to these services.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Improvements were needed to advocate for people when they were vulnerable to experiencing inequality in health care. For example, a person was waiting a long time for an important piece of equipment which without it increased their risk of falls. No advocacy and plan had been made to address this inequality this person was experiencing. Another person had been advised they needed to eat a certain diet in hospital which they disagreed with. No follow up referral had been made to question this and promote their safety, until we prompted a manager to do this.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff had received positive feedback from relatives about their loved ones end of life care at the home. However, this aspect of people’s lives was not always being considered in a meaningful way. Reviews into end of life care were not evidencing this subject had been spoken about in a way to support people to make plans for this moment in their lives. Even though staff had got to know some people well, their knowledge was not being gathered, explored, and documented to support this planning.