Welshwood Manor

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.Not all people were assisted with care that met their preferences and was person centred. Staff told us of people who were assisted to wash and dress from 4am at the direction of senior staff. One staff member described the practice as “inhumane” and described a difficult atmosphere for staff in the home if they did not assist people at that time.

Staff were employed to specifically support people to take part in activities, however, these were not person centred and there were not enough activities to keep people occupied, especially for those people who remained in their bedrooms or were care for in bed. A relative told us, “[Family member] has specific needs which includes interactions that are different to other people, but this doesn’t happen.” Another relative informed us, “Although we have been very happy with the care that [family member] has received and is receiving, in its current state, with a lack of staff, I don’t think I would recommend Welshwood Manor. My [family member] has vascular dementia and issues with her mobility and she does not show much interest in joining in any activities, but she does seem to enjoy watching others. However, since [activities staff] left, far fewer events have gone on. There were a few visits with animals that [activities staff] arranged and [family member] really enjoyed those. There were visits with kittens, goats and a Shetland pony.” A third relative commented, “When I looked around the home prior to my [family member] going they told me about all these activities they do 5 days a week. The activities organiser at the time was excellent with the residents and they were always doing something new. Sadly, after she left it has gone down to virtually nothing. d.The person doing it now also works in kitchen, so this arrangement is clearly not working. What worries me is my [family member] is not being stimulated and will go downhill.”

People who spent time in their rooms, as well as those who were living with dementia or who were cared for in bed, were more reliant on staff to meet their needs. However, due to staff's workload and their resulting task-focussed approach this meant that people were at risk of social isolation. People who spent their time in their bedrooms had little or no stimulation, only that from staff performing a care task. Coupled with the lack of call bell system that enabled people to seek staff assistance and company should they have wished for it meant people were at risk of social isolation. One person’s relative told us, “Previously the management were exceptional in ensuring [family member’s] needs were met. They would go above and beyond to try and help [family member], especially thinking of their mental well-being… taking the time to engage with them on a more personal level - unfortunately all of these staff have left.”

Care was observed to be task based. Task-based care is when support is planned around set tasks for example, personal care or support with meals, this is done in a fixed time rather than focusing on the person’s overall needs or preferences.A relative told us of their family member’s preferences and how despite being reasonable requests, they were not being met.

Staff did not maintain high-quality person-centred care records. Information recorded in people’s care records was not person-centred and did not provide an accurate view of their lived experience. Some language in people’s care records was judgmental and not supportive and enabling. For example, the use of ‘bed bound’ and ‘suffers with’. This language is not person-centred; it labels people by their health conditions rather than a person with individual needs.

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. We saw and were told about situations where people had not been supported to access the care they needed in a timely way. For example, one person who needed to see their GP had not been added to the visit list so did not receive the consultation they needed in a timely manner.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider did not always ensure important information was provided to those who needed it such as for those people living with dementia. Many relatives told us communication from the service was poor.

We were not assured this service met the requirements of the Accessible Information Standard (AIS). The AIS is a law to make sure that people who have a disability, impairment or sensory loss receive information they can easily read or understand. The provider did not present information to meet people’s individual communication needs, for example, providing documentation and information in different formats such as in pictorial form.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result. People were not partners in their care arrangements and involved or supported in the decision making process even when it was about them.

Relatives spoke of poor communication within the service which limited their opportunities to engage about their family member’s care. One relative said, “I have sent several emails about different things, and they rarely respond. They also have had a problem with their phone lines making communication impossible. To me, this is not acceptable. I cannot communicate [with the care home] and quite rude not to answer an email.

Systems and processes to log any complaints received were not effective and did not record all concerns raised to enable the provider to listen to feedback and take appropriate action where required.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were not 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.

The service did not have good systems and processes in place to help ensure people’s wishes and needs were known and respected in relation to end-of-life care. For example, as circumstances changed, care plans were not always updated to provide staff with new guidance. For example, one person’s care plan stated in every section they were on end-of-life care. However, this was no longer accurate, and their care plan needed to be updated to reflect how staff should support them now.

Staff told us people received good end of life care at Welshwood Manor. One staff said, “Generally end of life care is good, relatives are supported throughout the stages of end of life.”