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Archived: The Old Rectory Inadequate

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Inspection report

Date of Inspection: 26, 27 June 2014
Date of Publication: 9 August 2014
Inspection Report published 09 August 2014 PDF

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 26 June 2014 and 27 June 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by other authorities. We talked with other authorities.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People’s privacy, dignity and independence were respected. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

Reasons for our judgement

We spent time talking to people who used the service, observing their day to day activities and their interactions between staff and other people. We found that the routines in the home formed a structure for the day and people said they were happy with this. There was some flexibility to the routines because staff were responsive to people when they asked about their personal care, wanted refreshments and wanted outings to be arranged on an individual basis. The provider may wish to note that the numbers of people using the service compared to the staffing and the way the home was organised may restrict people’s experience of individualised care.

People who used the service were provided with some opportunities to be independent and for community involvement. Some people were independent and able to manage road safety, used public transport and purchased items in shops with an awareness of money. Other people were able to go out with staff support to participate in these activities. There was some turn taking in individual activities that required staff support due to the number of people using the service. Some people told us they had lived in the home for a long time and had got to know people in the village, at the local shop and pub. One person said, “I go out quite a lot. I like it here.”

The provider gave people opportunities to participate in community projects and events that were run by the provider. People talked about these projects with enthusiasm and told us about the jobs they did. One person spoke about gardening. They said they enjoyed it and together with other people they talked about the vegetables they had planted and watched grow. People said they were excited because some of the produce was ready and was being cooked in the meals that week. This meant that people were involved in activities that were meaningful and of value.

People who used the service were supported to say how they wanted their care to be given. Meetings were held with some people to enable them to discuss the routines in the home and their care. Minutes were taken and action agreed in response to suggestions. People who had communication difficulties or who were less confident needed more support for their views to be heard separate to the meetings. There was no documentation to show that individual meetings with people who needed additional support took place.

People with communication difficulties had been referred to the speech and language therapist and had received advice and support. We saw communication assessments in care plan folders. These included descriptions of known gestures people used and their meanings, pictures of their own modified versions of Makaton sign language and ways that individuals usually communicated.

We observed staff talking with people using signs and gestures. For example, we saw one person discussed their care routine using signs and gestures and agreed who was going to assist them that evening with a member of staff. The staff member explained that the person liked to choose each day who was going to assist them with their personal care in the evening.

One person had a communication passport. This gave staff and other people guidance on how to communicate with the person and what each sign they used meant. The staff explained that they regularly printed new versions of the passport because the person tended to destroy it on occasions. We saw staff talk with this person and responding to the signs used. We requested to use the communication passport to help us to talk with this person. This was unavailable for both days of our inspection which meant that people who did not know the person well could not communicate with the person effectively.

We saw people being offered day to day choices. Staff explained that they supported people who were non-verbal with choices by showing them the options. For example, choosing between items of clothing held up and we saw people being shown the plates of