The Red House Welfare & Housing Society

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 Inadequate. This meant services were not planned or delivered in ways that met people’s needs.

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

This service scored 25 (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 consistently work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

The provider did not consistently take a person-centred approach to care planning. Care records were often unclear, inconsistent and not kept up to date, which meant staff did not always have reliable guidance to meet people’s individual needs safely.

The provider did not consistently place people at the centre of their care planning or work in partnership with them to respond to changes in their needs. For people living with dementia, their care plans did not consistently describe how the condition affected them as individuals. There were no specific, detailed care plans to guide staff on how to provide personalised support to people throughout their dementia journey. This meant staff lacked clear direction on how to meet people’s changing needs.

In addition, some records contained conflicting information. For example, one care plan stated a person had good skin integrity, but another section of their care plan referred to a pressure ulcer. Where people required support with their hydration needs this was carried not carried out effectively. Another care plan stated a person showered independently but then said they required 1 member of staff to support them.

People and relatives told us they were not involved in care planning or review.

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

The staff did not identify and take appropriate action when they were no longer able to support a person effectively and safely. The local authority assessed the needs of a person living at the service during our inspection which resulted in the person moving to a different service as the local authority concluded their needs were not being met.

The service had not recognised that the needs of some people had increased overtime whilst other people were more active.

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

Whilst there was a service user guide in place, this was not available in alternative formats such as large print. Ensuring information is accessible is important to promoting people’s autonomy and informed consent. This left people at risk of not being fully informed about their rights and choices in the service.

Some people living in the service were living with dementia or a cognitive impairment. Care plans contained a section entitled Choice and Communication however, this was not detailed and did not support staff to communicate with the person. For example, 1 person’s care plan stated staff would know by their facial expression and body language what they wanted. The care plan did not detail what expression or body language the person would show.

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.

We requested but were not provided with any surveys carried out by the provider to gain feedback about how people felt about the quality of care they received.

We saw various communications regarding individual complaints, and there was a complaints policy. However, there was no central system or process to record and monitor complaints. The registered provider was unable to demonstrate individual complaints were responded to appropriately and that follow ups with people were looked at and reviewed.

It was not always clear whether people had been involved in decisions about their care. In many cases people’s mental capacity to make decisions had not been assessed. There were no records to show how people and those important to them were involved in the decision-making process. People and their relatives could not confirm they were actively involved in the planning and review of care and support.

The provider did not make sure that people could access the care, support and treatment they needed when they needed it.

Care plans demonstrated that referrals were made to external professionals. However, these were not always made in a timely way. This meant treatment or advice could be delayed resulting in the condition deteriorating.

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 and opportunities to tailor care were missed.

We were not assured people’s care always promoted equality and protected their rights. A person told us, “Staff are busy, lots of people here now with special needs, I sometimes feel overlooked by the carers, think it is as I am capable, I can ring and do occasionally and they come within a few minutes.”

We were aware that recent night shifts had not always reflected individuals’ preferences regarding who provided their care and support, including if they had met them before or if they were male or female. This created a risk that people may have felt uncomfortable receiving support or may have chosen to decline care, potentially impacting their dignity, choice, and wellbeing.

A person told us, “Staff are busy, lots of people here now with special needs, I sometimes feel overlooked by the carers, think it is as I am capable, I can ring and do occasionally and they come within a few minutes.”

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.

Care plans lacked evidence of consultation regarding individuals' future wishes and were not consistently updated to reflect their changing health conditions. This meant people’s future care needs and preferences were not always fully considered or planned for effectively. The lack of meaningful involvement /consultation and regular updates put people at risk of receiving unsafe, reactive care that disregarded individual choices.