Scholars Mews 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

Staff responded to people's individual needs and supported people in a person centred way. Staff now encouraged people to increase their emotional, social and physical well-being. A variety of activities took place which were in line with people's interests. Staff communicated with people in a way they could understand. Although people felt listened to in their day-to-day care interactions, people and relatives did not always feel involved in reviewing their overall plan of care. People and relatives told us they felt able to raise any concerns or issues and were confident they would be responded to. People told us they had equal access to care and treatment and they had not experienced any discrimination. Further improvements were required to support people in planning for the future.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were cared for in a person centred way and staff were responsive to their needs. One person told us, “They do things the way I like it. I am not unreasonable. The staff do listen to my requests for help and respond nicely.” Another person told us, “I feel listened to. Whenever I ask for a shower, they do it.” However, people and relatives did not always feel staff worked in partnership by involving them in reviewing people's care. One relative told us, “I don’t think they do care plan reviews with me as I would remember.” Another relative told us, “I have not been involved in reviews for [person’s] care needs.” Another relative said, “Yes, we are involved in the care plan, but [person] did not have a care plan review for 2 years. This is not done regularly.”

Staff knew the importance of providing person centred care. At our previous inspection, there was a culture where staff did not encourage people to use the communal areas so people spent a lot of time in their bedrooms. People's preferences were not always met. At this assessment staff told us this was the biggest area of improvement for people. One staff member told us, “There have been lots of improvements with everything. The main thing being the offer of activities. We really encourage people to take part in the activities as they are good for people's well-being.” Another staff member told us, “What I will say has improved is staff are more proactive in encouraging people to spend time out of their room. That has Improved massively, and people are in the lounges. It was a cultural shift. People's emotional well-being has improved as there is plenty of things to engage people now.”

People received care and support in line with their individual preferences. People got up and went to bed when they chose. For example, during our night visit 1 person had chosen to stay up with a beer to watch the football. People were engaged in a variety of activities to enhance their social, emotional, cognitive, and physical wellbeing. For example, 7 people engaged in an activity in the lounge to aid their cognition. Care plans were written in a person-centered way and described how people liked their care to be delivered.

People and relatives provided generally positive feedback about the continuity of care. One person told us, “I would say something if needed but no need. My care here seems well coordinated.” However, 1 relative told us about a lack of co-ordination when their parent was admitted to hospital following a fall.

Staff told us they worked well with other healthcare professionals to ensure people received joined up care. Staff reported no concerns in accessing services for people when this was needed and felt when people returned from hospital, enough information was provided to ensure their healthcare needs were met.

One healthcare professional gave examples of where continuity within people’s care needed to be improved and commented, “Continuity can be a challenge”. They explained that when instructions had been given to make changes to people’s care and treatment, it had not always been done in a timely way. For example, 1 person had been prescribed an increased dose of their medication which had not been implemented before their next review. Although improvements had been made, when reviewing people’s health, it was not always easy for healthcare professionals to find important information to aid an effective review. One healthcare professional told us, “You have to look all over the place as information is not recorded in one place so things can be missed.”

Records did not always enable staff to effectively review a person’s care. One person had recently had a medication change to aid their sleep pattern at night. However, this was not being monitored effectively to enable a co-ordinated approach to managing this need. Another person had an increase in medicines due to their levels of distress. Staff did not routinely complete monitoring charts to enable an healthcare professionals to make a clear judgement on the effectiveness of this medication. Records showed some monitoring, but this was not easy to navigate. Without having clear information, it was not always clear if people were receiving care that was joined up and co-ordinated.

Staff communicated with people in a way they could understand in their day-to-day interactions with people. One relative told us, “The staff are very patient with [person] and speak clearly to his right ear, as they are hard of hearing.” Another relative told us, “Staff listen and speak to [person] in a way [person] understands them.”

The Operations Director told us people’s communication needs were assessed before people joined the service in order for them to gain an understanding of the person’s needs. Staff understood that people had varying communication needs and knew where to find this information in people’s care plan. We saw staff speaking to people in a way they understood. One staff member was seen patiently reading out the menu to a person who had poor eyesight.

People’s communication needs had been assessed and care plans informed staff how to communicate effectively with people. For example, keeping sentences simple and not overloading people with information. They also gave clear guidance about any equipment people needed to support their understanding such as hearing aids, glasses etc.

Although people felt listened to in their day-to-day care interactions, people and relatives did not always feel involved with their overall care plan. Comments included, "No care plan has been discussed since [person’s] first assessment", “I think about 4 years ago I had a meeting, but I have not seen the care plan for years“ and, "I’ve never had a review and no care plan that I know of.” People and relatives told us they felt able to raise any concerns or issues and were confident they would be responded to. One relative told us, “I have not needed to raise any issues, but I am confident they would act on them if I did.” Another relative told us about a concern they had raised with the manager and confirmed, “They acted up on it straight way in two days.” People told us, “I am listened to, they are very helpful” and, “If I need to make my views known I do, they listen and act.”

Staff understood the importance of talking to people regularly to identify any issues before they could develop into complaints or concerns. The Regional Director told us they conduct daily managerial walk arounds where they would talk to people to ensure they had no concerns. They explained people and relative meetings were now happening regularly and, in these forums, people and relatives would speak up about any concerns they had. The Operations Director also confirmed they had sought people’s and relative’s views recently via a quality questionnaire. The regional director told us people’s care plans were reviewed with people and where appropriate, their relatives.

At our last inspection, people and their relatives did not always feel confident if they complained they would be listened to. However, over the past 6 months improvements were being made and records showed people and relatives were gaining trust with the provider. This was showed in meeting minutes and surveys. Information was available to people around the home about how people and their relatives could give feedback about the care provided at the home. The provider had a complaints process and we saw evidence of this being followed. However, records did not always show people’s care and treatment had been assessed, reviewed and communicated with them. Although leaders have described processes for involving people and their relatives in care plan reviews, the feedback from people demonstrates this was not effective.

People told us they had equal access to care and treatment and they had not experienced any discrimination. One person told us, “I’ve never observed discrimination here.” Another person told us, “There has been no discrimination at all that I have ever witnessed.” People accessed care, treatment and support when they needed it. 1 person told us, “I get what’s needed, they give me the support that’s required.” Another person said, “There are no problems seeing the doctor or dentist and I went to Specsavers they took me.” Another person commented, “They are very quick in sorting things out.”

Staff did not raise any concerns about people not being able to access services when they needed it.

Healthcare professionals did not raise any concerns about people being unable to access care, treatment and support when they needed to. One healthcare professional explained timely referrals were made to other healthcare professionals and explained, “They are referring people out to dietitians. I reviewed someone who had lost weight and I didn’t have to ask, I could see the referral to the dietitian.”

Records showed people had regular access to healthcare professionals such as the GP, frailty nurse, district nurse and dietitians. We found no evidence that people did not have access to services they needed.

People reported receiving the standard of care described in this quality statement. People understood their right to be treated equally and fairly and were provided with the care and support they wanted based on their specific needs. People were engaged and supported by staff to be included and have the same opportunity as others to receive the care and support of their choice. People described staff as kind, caring and compassionate. One person said, “They (staff) are all very good. If they don’t know something, they go and find out but they usually know the answer to everything."

Leaders and staff are aware of discrimination and inequality that could disadvantage different groups of people. The regional director told us, “We have had no issues with people being discriminated against because of their illness or disability but we would absolutely challenge that if this were to occur.”

The provider had policies and processes in place which enabled them to continuously seek feedback from people to tailor their care, support and treatment.

Relatives did not always feel involved with end of life planning. One relative commented, “No end-of-life care plan has been discussed for 2 years with me. They have not discussed end of life with me.” Another relative commented, “No, the staff have not discussed this with me. [Person] filled out a respect form but has not discussed a specific end-of-care plan.” Another relative told us, “We have discussed resuscitation, but no care plan has been discussed for end-of-life planning.” This feedback demonstrated this was an area that remained a work in progress.

The Regional Director told us, “We discuss end of life wishes with people. Some people chose not to talk about this, but we try to get a steer on what their preferences are anyway. We have started to do memory books when people pass away for their families to keep. It has pictures in of their time here and pages for staff to write their favourite memories of the person or messages to the family on their loss.” One staff member explained the importance of providing good end of life care because of the peace it brought to the person’s family.

Records demonstrated where people had discussed their plans in the case of a significant illness or their wishes for how they wanted to spend their final days. This had been recorded and people's end of life care plans were in place. However, feedback from people and relatives showed processes for discussing individual wishes with people and relatives were not always effective.