Duke Street Bungalows

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 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.

People did not consistently receive person centred care as they had not always been involved with all care decisions and the care they received was not always individual to them as reported on under treating people as individuals.

We also found people had an ‘aspirations for the year’ poster in place. However, there was no evidence to show how these aspirations had been decided and agreed with people and how people had been involved with choosing or deciding these. The registered manager and staff told us they were based on staff knowing people well. Furthermore, we viewed 3 of these for the people living in 1 bungalow and they all had the same aspiration. This meant people’s individual wishes may not have been fully considered.

However, there was evidence in care plans to show the provider had considered some preferences, likes and dislikes. Staff told us they knew people well and what was important to them.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

There were systems and processes in place to ensure people’s care was reviewed and updated. The provider ensured there were systems in place to share this information or changes with staff so people could receive consistent care.

The continuity the staff team provided had positive outcomes for people as this meant they knew people well. Most staff had been working at the home for a significant period of time. Each member of the management and staff team knew people well. A relative told us, “They are such long standing members of staff, it's a credit to them”.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Communication care plans were in place and detailed how people chose to communicate, they provided examples of what people may do if they were happy or sad. Further improvements were needed to ensure detailed information was available to show how they made day to day choices and were involved with key decisions.

Information was provided to people in a format or language they could understand if requested. Staff were aware of people’s communication needs, what this meant for people and how to offer support with this.

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

Feeback was sought from relatives and health professionals, however it was unclear how all people gave their feedback. There were no records to show how people were currently involved with their reviews of care. There were records to show families involvement and some people had access to advocates. Annual reviews for people had not been completed since 2024 and these did not always reference people’s input. For example, the registered manager told us 1 person attended the review, however the records did not show this.

People had monthly reviews which included a section where the person could give feedback, some of these sections were empty, and some were a review of the month for the person. Although there was a picture of a face to represent how the person had felt that month, there was no evidence to show how the person had reached this decision or how they had been involved. Staff were unable to confirm if people had always been part of these reviews. The registered manager told us that meetings for residents did not take place and therefore it was unclear how people always shared their views.

However, people and relatives told us they knew how to raise concerns and were confident their concerns would be listened to. One person said, “I would tell staff”. A relative said, “I'd go to the Manager with a complaint. I'd be happy she'd deal with it”.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People and relatives raised no concerns with the access they had to other health professionals.

The provider told us they worked alongside external agencies whom they could engage with if needed.

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

As people’s care was not always tailored and delivered in line with the right support right care right culture guidance, we could not be assured people always received equitable experiences. We found records needed improvements to show and ensure people were involved with all aspects of their care and they were involved with reviewing and key decision making.

Some of the wording in care plans need improving to ensure all people were supported in an equitable way. For example, in 1 person’s care plan we saw recorded, ‘Staff to follow Positive Behaviour Support Plan (PBS), if my behaviour is inappropriate.’ The use of the word inappropriate meant people with learning disabilities were not always described with language that was suitable or dignified.

Other information we viewed showed that person centred care was not always fully delivered. For example, 1 person who enjoyed walking had written in their care plan ‘I do require support from 1 member of staff; they can be supporting another resident. I am very happy to tag along’ the provider had not considered the impact and experience this may have on the individual care the other person should be receiving.

Furthermore, we also found care plans were not always up to date, and they did not always reflect changes, which placed people at risk of not receiving an equitable experience.

However, staff were aware of potential inequalities people receiving support may face and considered how protected characteristics may impact their care experience.

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.

People had ‘end of life’ plans in place, which lacked information and involvement from the person. The plans we reviews stated, ‘I do not have the capacity to decide what I would like to happen at the end of my life. In place there is a Residents Carers wishes form that my parents have completed stating what they think I would wish at this time’. There was no evidence to show how people had been involved with this. There was no further information available about the specific needs for people, placing them at risk of not receiving the support they wanted or needed during this time.

Care records contained no evidence of goal setting or planning for important life changes. One person had achieved a positive outcome and they now were involved with collecting their own money from the cash machine. However, the registered manager confirmed there had been no goal setting for this and no plan as to how the person could achieve this at their pace, utilising the support they may need. The registered manager confirmed it was something that happened over time and staff had led on this. People’s annual ‘aspirations’ had not considered these events.

There was nobody currently being supported with end of life care and people or relatives raised no concerns to us.