Ailwyn Hall

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 requires improvement. 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 36 (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.

People who used the service did not receive individualised care which met their needs. High numbers of agency staff on each shift meant there were multiple staff who were not familiar with people’s needs. Poor processes further impacted negatively on people. Care records documented needs and preferences but were not always accurate or complete. One person who had previously been an inpatient for many months in a psychiatric hospital had no mention of this in their care plan which noted only dementia and depression. Another had experienced significant and recent mental trauma, and this was not referenced anywhere in their care plan.

Through the Resident of the Day initiative, relatives told us they had been asked to be involved in decisions about their family member’s care and treatment. However, feedback about this was mixed and some relatives did not feel partnership working was always in place with them.

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.

Staff received mostly online training, however this did not cover all the specialist areas needed to ensure people’s needs were met. For example, several staff did not have a record of having completed dementia awareness training. We found environmental factors had not always been considered regarding people living with dementia. We noted multiple times that the radio and television were on in the same room and people gathered together in one large room rather than be enabled to experience quieter spaces. Staff showed limited awareness of how this might impact some people.

A high number of incidents of unexplained bruising had not triggered the level of further investigation and onward referral which should have followed. Although the new management team were in the process of addressing this, we identified some further issues which needed attention.

People were supported to access community healthcare appointments for both routine and specialist services. However, some routine appointments for dentists and opticians were considerably overdue.

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

Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard (AIS) tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it.

People who used the service and their relatives told us they didn’t always feel fully informed about all aspects of their care or the staff changes at the service. Communication was not robust. We noted appropriate signage around the service to help guide people around, especially those living with dementia. However, boards displaying recent activities were left empty. Photographic menus were in place, but they did not always reflect the meal actually being offered, which was confusing for people. We observed some people being shown individually plated meals to help them choose which was good practice. One person required communication aids and these were in place and staff confident in their use.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

We reviewed complaints held on file and found only one despite multiple relatives telling us about complaints they had raised both formally and informally with the service in the last year. Two relatives we spoke with were extremely distressed about the number of times they had tried to discuss their concerns with the provider without satisfaction or clear action following.

The provider was required to inform relatives about a serious safeguarding investigation which had taken place at the service. While 2 relatives were spoken with individually, others were called to a communal meeting where their concerns and questions could not easily be aired due to issues of confidentiality. A wider meeting was held with relatives of a further 4 people who used the service, but no provision had been made to share the concerns with other relatives and families who were unable to attend this meeting.

We received mixed feedback about how involved people, and their relatives, felt. One relative told us, ‘The support group [for relatives] at Ailwyn runs at 10am in the morning which is not a time that [I am] able to attend. I requested that it could be in the afternoon or evening and nothing was discussed.’ Another relative commented, ‘It would be nice to have an update [about my relative] sometimes. I have had none.’ However other relatives were positive about the opportunity to share feedback and raise issues if needed. Resident meetings had not been taking place, but staff told us these were being re-introduced.

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

Staffing concerns meant sometimes people waited for the care and support they needed. We observed people shouting for their meals as they were very delayed and other people waiting to go to the toilet. Staffing levels in the evening and at night were low and we could not be fully assured people would have their needs met promptly. Staff confirmed this was often the case, especially when something unexpected happened or there was an emergency.

People had call bells in their rooms although many people living with dementia were not able to use them effectively and relied on staff to monitor and check them. The premises were accessible with lift access to the upper floor. We found some bathrooms and toilets were locked making them inaccessible to those people who were independently mobile and required them to find staff to unlock them.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

Most staff had completed training in equality and diversity, although some had no record of receiving this. The service states on its website it provides care for people living with moderate and advanced dementia. We found some people at the service had highly complex needs which did not always relate to dementia. Staff did not all have the skills and training required to support some of these needs and care plan systems did not assist them as information was incomplete and contradictory in the plans we viewed. One relative commented, ‘The service seem to take people who are very complex and I don’t think staff always have the skills.’

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.

People were supported to plan for important life changes including end of life care. Records relating to this were detailed, regularly reviewed and contained enough information to guide staff on how to support the person in the way they chose.