Maesbrook 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

changed to requires improvement. This meant people’s needs were not always met.

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 always ensure care was centred around people’s individual needs, preferences, or routines. People described care that fitted around staff routines rather than their own choices. Staff we spoke with confirmed this routine-based approach due to staffing shortages.Some people felt staff did not have enough time to learn about them or consider their preferences. One person told us,“There’s some really caringstaff,but they never have enough time”. Another person said they felt distressed at night whenhearing doors because staff did not fully understand their anxiety linked to past experiences.There were some individualised approaches. However, these positive examples were outweighed by the lack of consistent personalised care planning and delays in support which impactedpeople’s dignity and comfort.

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. Care was not consistently coordinated or delivered in a way which ensured continuity or met people’s changing needs. People experienced delays in support with toileting, washing and night-time reassurance. These delays created distress for individuals, including those with high falls risk, continence needs, or mobility difficulties. Some relatives reported repeated instances of unmet continence needs leading to significant distress.

Although some staff attempted to follow people’s preferences and provide consistent care, this was not reliable. Relatives described inconsistent communication and a lack of follow through on required actions, including monitoring health concerns or maintaining supplies of continence products. Care plans were not updated or reflective of people’s personal preferences and wishes.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People and relatives did not always receive clear, timely or accurate information about care, charges, or changes. We found people and relatives were unaware of extra costs until invoices were issued, including fees for toiletries or the use of water and electricity for hairdressing, saying no one had explained these charges in advance. Some relatives told us communication was inconsistent and sometimes dismissive. One relative described requesting information about health concerns but stated, “I had asked that they continued to do [person’s] observations, but they hadn’t and they deteriorated. ”Further relatives told us they struggled to get explanations about new medicines or changes to care. Some people and relatives told us staff communicated well, one relative told us, “They keep us informed and work with us”.

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. The service did not ensure people were consistently listened to, involved in decisions, or treated as partners in their care. Most people described feeling dismissed or ignored when expressing their needs. One person said despite asking for help repeatedly,“I have to always keep ringing the bell, I am not sure if I am muted.”

Relatives described raising serious concerns that were not acknowledged or acted on, including incidents involving safety, deterioration in health, or issues with dignity. One person said,“It’s the culture, poor communication makes me feel overlooked”and described frustration in repeatedly raising issues without change.Some people reported not knowing the registered manager or feeling unable to approach them. One person said,“I don’t know who it is, no one’s come to introduce themselves”.This lack of visibility and engagement limited people's involvement in shaping their own care.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Access was limited for some people due to delays responding to call bells or difficulty obtainingtimelysupport with transfers or toileting. One person said they, “always have to wait” for help to get to the toilet due to staffing pressures.

Most people could access the service and the support available within it. Relatives described staff as approachable and willing to help, and many said there were usually enough staff around during visits toassistwith immediate needs. Most relatives told us they had no concerns about accessing the home, visiting, or speaking with staff, and some said they always felt welcomed when they arrived.Staff supported people with mobility needs to move around the home, and people were supported to access the dining room or lounge whenappropriate. Some people chose to stay in their rooms, and staff respected these choices.However, while these delays affected people’s experience, they did not prevent access entirely.

Staff and leaders did not always actively listen to information about from people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. People did not experience consistently good outcomes due to variability in care delivery and responsiveness. Some people received warm, respectful interactions, and relatives spoke positively about staff kindness and care. However, others experienced poorer outcomes, particularly those reliant on staff for continence care, mobility support or reassurance. Some relatives raised repeated concerns about people being left distressed, and one person described a decline in wellbeing linked to poor communication and unmet needs. People who were anxious or had cognitive impairment sometimes received limited reassurance or inconsistent emotional support. People with sensory or communication needs did not always receive equitable support.

People were mostly 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. Some people had missing or incomplete care plans. This included significant health needs, and delays in receiving assessments from external professionals affected planning for one person recently admitted from another service.

Relatives we spoke with described being contacted when their family member’s health needs changed and said staff involved them in planning. One relative said,“They once called us at night because they’re on palliative care and they were deteriorating.”They appreciated staff involved them.Some people had clear assessments and care plans in place, and relatives described involvement in decisions about rooms, routines, and preferences. People moving into the homegenerally settledwell with support from staff and families.However, this was not consistent.

Although there were gaps, the majority of evidence demonstrated staff worked with people and families to plan ahead and respond to changing needs.