Pear Tree Residential Care 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 50 (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 did not always reflect person-centred care and make clear people's needs and wishes. Staff knew people well and knew how to meet their needs safely; However, care plans did not provide sufficient information to guide staff on how best to meet people’s needs. Care records did not always include information about people's history, past employment, hobbies or past times. The registered manager told us this was something the new activities coordinator was going to work on.

Care plans did not reflect family’s involvement in people’s care within the service, although we saw that family played an important role in many people’s lives.

The provider understood the diverse health and care needs of people and their local communities.

Most of the staff at the home had worked at the service for a long time although there had been some recent turnover of staff, this was beginning to stabilise. The registered manager told us there was good continuity among visiting professionals. The GP would visit the service once a fortnight and the same district nurses attended the service.

The registered manager felt there was a good working relationship with external health professionals and we received no concerns.

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

Communication care plans were in place for people to outline their communication needs. There was no evidence of information being shared with people around their care and treatment. We saw how the service had started to introduce pictures of the food they were serving on the communal menu board; however, this was not fully established as there wasn’t pictures available for every meal. Individual menus and a timetable of activities were not available in an accessible format, and we saw no easy read information within the service for people who required this.

At our last assessment we raised concerns about how peoples care records were stored as they were not secure. On the first day of the assessment, we noted that no changes had been made to how records were stored. We raised this with the registered manager who rectified this.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

We saw feedback from people was only focused on food and had been carried out 6 monthly. No feedback was sought on care, the environment, activities or other areas that could be important to people.

There were no meetings for people or their relatives to share updates or seek feedback. We saw questionnaires from families completed; however, these were not always dated, and we saw no evidence of feedback evaluation. Relatives told us they would be happy to approach the registered manager if they had any concerns.

The complaints policy lacked essential information, such as how a complaint could be appealed or escalated if a person was not happy with the outcome.

The provider did not always ensure that people could access care and support in a way that worked for them. Systems intended to promote equitable access were in place but were not consistently applied.

Care plans did not always accurately record people’s needs or the support required, limiting assurance that everyone had fair access to safe, appropriate and person‑centred care.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes.

The provider did not make Equality and Diversity training available to staff, despite the providers Equal Opportunities Policy stating training would be made available to staff. The training policy did not include Equality and Diversity training. As a result, we were not assured the provider consistently considered people’s protected characteristics or made reasonable adjustments to remove barriers to care.

The Equal Opportunities Policy also stated, “All service users have six monthly reviews and six weekly meetings with management where they can express their views without fear of discrimination”. The registered manager told us that reviews were not carried out for self-funding residents, only those funded by the local authority. The provider failed to promote equitable experiences and uphold people’s rights.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

People did not always have opportunities to be involved in their care planning and day-to-day living including activities within the home.

End of Life care was considered and recorded; however, not all staff had received training in end-of-life support.

One relative told us, “When my relative passed away last year I was contacted by the night staff and went straight in. They looked so peaceful and comfortable. I hadn’t met any of the night staff before. One of the carers sat with me and made a cup of tea, they were so kind”.