North Bay House

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.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 46 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

The information staff had access to in care records lacked vital information about people’s specific needs, wishes, interests and goals. There was a lack of information including childhood and early life history, work history and significant places and life events to encourage reminiscence, which could help people living with dementia retrieve past memories. By understanding people’s life story, staff could better connect with them, address distressed behaviours, and create a more person-centred approach to care. We found the service had not done this. Care plans did not fully explore people’s ability to make day to day decisions. People did not always feel in control of their care, and several people were not aware of having a care plan.

We spoke with the management team about the lack of person-centred care and clear guidance for staff on how to support people in a person-centred way. The management team stated they were completing immediate reviews and would include people and their families where appropriate.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff did not always have training to meet the needs of the service user group, such as specialist training and skills needed for the people they supported. One person told us, “Some staff are good and some are not. I think this comes down to training.” There was a lack of systems to ensure there was detailed and up to date information about people’s needs and how these were communicated to staff. Often posters were added to the staff room notice board about people’s needs, however, there were numerous posters, and there was a risk that important information could be missed due to the volume of information displayed. Care records contained discrepancies and incorrect information, which meant we could not be assured that detailed and up to date information could be provided to other organisations to ensure person-centred and continued care would be provided.

There was a consistent staff team, so people were familiar with staff providing their care.

The provider did not always supply appropriate, accurate and up-to-date information. Some people were not aware of having a care plan and had therefore not been given an opportunity to access their care records and contribute to the content. People’s care records contained information on how to effectively communicate with them, and specified sensory losses, such as reduced hearing.

The provider and registered manager failed to demonstrate consideration had been given to allow people to move freely and independently around the home. For example, clear signage was not always in place to support people to find their bedrooms or bathrooms. Information about activities in the service was displayed on a wall in the hallway. However, this information would have been too small for some people to read.

People’s records were stored securely on an electronic system. Staff received GDPR (General Data Protection Regulation) training that describes how organisations should handle the personal data of individuals. The regional manager told us that people were able to have large print formats of relevant information if needed, for example the service newsletter.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

We saw evidence of some resident meetings which gave updates and opportunities for feedback. However, these meetings were not attended by all people living in the service. There was no evidence of how all people, including those living with dementia had been supported to participate in this process. Therefore, we could not be assured all people had been given the opportunity to provide feedback and make suggestions about the care they received. Further,resident meetings did not explore how people were experiencing the care provided, which would open up discussions and help the provider identify areas for improvement. Not all people were aware of the resident meetings. One person said, “I don’t know [about resident meetings]. I’ve not been”. Another said, “I wouldn’t know about [resident meetings].”

The majority of people we spoke with told us they felt confident to raise complaints, concerns or suggestions, however, one person gave an example where they had, and did not feel listened to. A relative told us, “I would not have a problem in giving feedback and anything I suggested would be considered, I’m sure.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. We found that sometimes there were delays in referring people to external professionals, such as specialist support teams. One person said, “I’d like to see the GP a bit more, they never seem to come.” Systems and processes in place were not always effective in ensuring people were supported to experience equality in the care and support they received. For example, further improvements were needed to ensure people’s care was person-centred.

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. Records did not always show how people, and their representatives where appropriate, were included in the development and review of their care plans. There was not always evidence to show they were consulted and listened to about their experiences to ensure their care plans were tailored and suited to their individual needs and preferences.

Only 3 staff had completed equality, diversity and human rights training. We could therefore not be assured that staff understood equality, diversity, inclusion, stereotypes, and discrimination, and how to treat everyone with dignity.

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. People’s end of life care plans did not always include or fully detail information in relation to people’s spiritual and cultural needs, involvement of family and friends, reassurance about pain management and rapid support to medicines that may be required. The regional manager was aware that more detail was required and began updating this section of people’s care plans to ensure people’s wishes were known. Staff did not have end of life training to ensure they were equipped with the skills to deal with this area of people’s care.