Welshwood Manor

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• 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 requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 64 (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.

Care records were in place and intended to be person-centred, reflecting individuals’ needs and preferences; however, inconsistencies and inaccuracies were identified, meaning records did not consistently or reliably reflect people’s current needs. This placed individuals at risk of receiving inappropriate or ineffective care and demonstrated that improvements were required. The manager was responsive and acknowledged the concerns, taking action to address the required improvements.

There was an improvement in the activities and social engagement at this inspection. We saw people involved and positively responding to different activities during both of our inspection visits.

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.

Care records showed people had access to external healthcare professionals when needs were identified and escalated. People were supported by a largely stable staff team, which promoted continuity of care and helped staff develop knowledge of individuals’ needs, preferences and routines. However, systems for monitoring safety and identifying emerging concerns were not consistently effective. As a result, there was not always assurance that changes in people’s health, well-being or risk levels were recognised, reviewed and acted upon through effective management oversight. This meant opportunities to identify concerns and make timely referrals to relevant healthcare professionals were not always evident.

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

People’s communication needs were clearly identified within their care plans which included guidance for staff on how to adapt communication methods appropriately, supporting staff to share information in ways that individuals could understand and engage with effectively. This included the use of a white board and pen to aid communication for a person. This meant individuals were better able to express their needs, make informed choices, and actively participate in their care, reducing the risk of misunderstanding and promoting more person-centred, responsive support.

A relative told us, “There was always an annual relative meeting but there have been more meetings arranged latterly. [Manager] keeps us up to date with what is going on. [Manager] gave us a very detailed plan about what would happen – an improvements schedule. Minutes are taken and we receive an email afterwards outlining what was discussed. They have made a lot of improvements lately and I can‘t think of anything further that can be done.”

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.

There were incomplete care plans and inaccurate records. These indicated people did not have meaningful involvement in their care, the service development and improvement.

Most relatives told us they would be confident to raise concerns with the manager. One relative said, “If there was a problem I’d go to see [manager]. They are approachable and their door is always open.” This showed there were open and transparent communication channels with relatives, supporting confidence in the management of the service and enabling concerns and feedback to be acted on, which contributed to ongoing improvements.

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 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 told us people received good end of life care at Welshwood Manor. One staff said, “I think we deal with end of life care very well. We offer families the option to stay over when the time is near. We offer food at mealtimes, and they have access to hot drinks day and night. We try to make family,comfortable and feel at home as much as we can. We also offer comfort and support.”

The service supported people to plan for their future, and we saw evidence of sensitive conversations around people’s end of life care needs. Do not attempt resuscitation (DNAR) decisions were documented and accessible to staff.