Alicia 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.

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

This service scored 61 (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 plans lacked clarity about peoples’ sexuality and identity. For example, sexuality and identity plans stated people’s preferences were to be respected, but did not provide any detail about what these preferences were. Another care plan said the persons preferences should be discussed with them; however, the care plan had not been updated to reflect if any discussion had taken place. This meant staff did not always have information to support people in expressing their identity, despite care plans indicating people may have particular preferences which were not recorded.

Despite our findings, people told us they were generally happy and were given choices and opportunities to be involved when they wished. A relative said, “[Relative] has choice here, they get up when they want to and shower twice a week.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported continuity. The provider acted and worked with commissioners where a person’s care needs increased to secure and provide one-to-one support where this was required.

The provider was not always consistent in supplying appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For example, one person’s care plan stated they used an alternative method as their primary communication, the provider had introduced these methods to staff and promoted the use of them to help staff knowledge, however we found this was inconsistently deployed and had not been embedded into daily practice. Some staff were knowledgeable and able to demonstrate this communication method; however others were not and were unclear when asked. One staff member said, “In the first few weeks we had basic signs on the notice board, there has been nothing since then”. The use of visual aids was inconsistent in the service, for example, on day 1 there were no pictorial menus on display, however on our second visit these were displayed. Where appropriate, we found information was available in an easy read format, for example, the providers complaints process was displayed in people’s rooms.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. A relative told us, “There is an opportunity to express concerns, we have relatives’ meetings about every 6 months. I have also had a questionnaire.” Another relative said, “I feel I can suggest things to them. I introduced them to the singing cafe and now 11 people go.” We also saw evidence of changes in the food menu following feedback from people living in the service.

The provider made sure that people could access the care, support and treatment they needed when they needed it. We found people were able to access external health services without delay and the provider had worked with external professionals such as speech and language therapists and dietitians to support people.

We could not be assured staff and leaders actively listened to all information about people who are most likely to experience inequality in experiences and outcomes. We identified safeguarding concerns which were not known to the provider and had not been promptly referred to the safeguarding team until CQC brought this to their attention. Care plans did not always provide guidance on how to manage known risks.

We found some care plans did not contain any information about people’s end of life wishes and there was no information to indicate if a discussion had taken place. This meant 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.