Well Springs Nursing 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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

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.

We found inconsistencies within care records, observed periods where people sat without interaction from staff, and found limited evidence of personalised engagement for people who remained in their bedrooms or were unable to participate in group activities. Feedback from people and relatives indicated care felt task-focused and was sometimes influenced by service routines rather than individual preferences, including feedback about set bathing arrangements and expectations around when people got up or went to bed. One relative told us, “The carers like a routine – they do one person then move on to the next,” whilst another commented, "Staff don't generally go and sit with [person] for a chat, interactions are task focused."
However, staff demonstrated a good understanding of many people's histories, preferences and communication needs, and we observed examples of staff adapting their approach and responding positively to people's choices and wishes.
 

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 and relatives generally told us staff knew them well, understood their preferences and delivered care that met their needs. Staff were able to describe people's individual needs and routines, and external professionals spoke positively about communication and partnership working with the service.
We identified some areas where care planning, monitoring and recording processes could be strengthened to provide greater assurance that care was consistently delivered in line with people's assessed needs. For example, records relating to repositioning, continence support and bowel monitoring were not always fully completed. However, staff demonstrated a good understanding of people's needs and there was evidence that people received coordinated care and support.
Overall, people received care from staff who knew them well and understood their individual needs, preferences and routines.
 

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

Staff adapted communication methods to reflect people's preferences, including the use of accessible information, different languages and translation tools where required. We saw examples of communication aids and technology being used to promote understanding, engagement and independence. This helped some people to communicate effectively and remain involved in their care and support.
 

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People, relatives and professionals generally described managers as approachable and told us concerns were listened to and responded to appropriately. The provider used a range of methods to gather feedback and understand people's experiences of care, including resident and relative meetings, as well as surveys for relatives and staff. These helped to provide opportunities for people and those important to them to share their views about the service.
The provider monitored feedback and complaints and could demonstrate examples where learning had led to improvements in the service. However, opportunities remained to further strengthen how feedback gathered directly from people using the service was analysed and used to drive service development.
Overall, people and those important to them were given opportunities to share their views and contribute to improvements within the service.
 

People were generally able to access care, support and healthcare services appropriate to their needs.
Staff worked collaboratively with healthcare professionals, and records showed people were referred to and supported by external services when required. This included access to emergency and out-of-hours healthcare support. People benefited from support provided by a consistent staff team who knew them well and understood their individual needs. However, we found call bells were not readily available in communal areas, which meant some people were unable to independently request assistance and did not have the same level of access to support throughout all areas of the service. The provider was responsive to this feedback and took immediate action to provide people with call pendants where appropriate.
 

Staff and leaders did not always actively listened 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.

The registered manager confirmed the service had experienced difficulties obtaining suitable IDDSI Level 3 Halal meal options for 1 person, and the person's family had provided significant support by supplying food to meet their religious and dietary needs. We also received feedback, and observed, that opportunities for meaningful engagement were not experienced equally by everyone, particularly people with reduced mobility or those who remained in their bedrooms. One relative told us, "It's all very well if you can join in, but if you can't you just sit around doing nothing." However, care records considered people's cultural, religious and communication needs, and staff adapted their approach to meet individual needs, including communicating with some people in their preferred language to support understanding, engagement and inclusion.
 

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.

We found a person receiving end-of-life care did not have an end-of-life care plan in place, meaning the provider could not demonstrate staff had guidance about the person's wishes, preferences and care needs. We also reviewed 2 other people’s end-of-life care plans and found they lacked person-centred information about individual wishes, preferences and priorities for their care.
However, people had arrangements in place to support future decision-making, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions where appropriate, and records showed the service worked with healthcare professionals to support future care planning and treatment decisions.