Broadoak Grange

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 54 (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.

It was evident throughout the assessment that staff were committed to providing person-centred care. We observed a number of positive interactions between staff and people using the service, which demonstrated kindness and a genuine desire to support people. For example, one staff member told us, “When you are asked why are you here, it's because of the residents.”

However, we found that oversight and governance arrangements had impacted the provider’s ability to ensure that person-centred care was delivered consistently across the service. While staff demonstrated a caring approach, practices were not always aligned with person-centred principles.

People did not always have opportunities to engage in meaningful activities tailored to their abilities, preferences and goals. We observed limited stimulation during the inspection, with only one organised activity taking place, a game of bingo facilitated by a visiting student rather than as part of the provider's planned activity programme. There was no evidence that reasonable adjustments had been considered to support people with visual impairments to participate fully, meaning some people may have been excluded from opportunities for social engagement and meaningful occupation.

There were some shortfalls in how the provider understood the diverse health and care needs of people.

The service provided care and support to people living with dementia. However, we found not all areas of the home were designed or adapted in a way that effectively met the needs of people living with dementia. Opportunities to create a more dementia-friendly environment that promoted orientation, independence and meaningful engagement had not been fully explored.

During the assessment, we observed limited opportunities for stimulation and engagement, particularly for people living with dementia. Some communal areas lacked features, activities and points of interest that would encourage interaction, support reminiscence or provide meaningful occupation. The environment did not always feel welcoming, engaging or sufficiently tailored to the needs of people living with dementia.

The provider did not always ensure people received information in a format that met their individual communication needs. Although the registered manager’s safeguarding audit stated safeguarding information was available in an easy-read format, this was not observed during the inspection. People living at the service with visual impairments were not provided with information in adapted formats, and the registered manager confirmed alternative formats had not been used. As a result, the provider could not demonstrate they were consistently meeting the requirements of the Accessible Information Standard. These standards state that providers of publicly funded adult social care are legally obliged to ensure people with disabilities or sensory loss receive information they can understand, with the right communication support.

Care records did not consistently provide staff with guidance on how to support people with communication needs. For example, 1 person with a significant visual impairment had no detailed care plan guidance to direct staff on how information should be provided or how their communication needs should be met. Records stated information was given verbally and the person did not require additional communication support, despite their documented visual impairment.

The provider sought feedback through regular resident meetings and relative surveys; however, concerns regarding the lack of meaningful activities and stimulation were repeatedly raised by people and their relatives and had not been effectively addressed. One comment received from the relative’s surveys in the summer included 'Residents appear bored with no stimulation and staff don't have much time to engage.' Records also showed staff had also raised the need for an activities coordinator to support people's wellbeing during staff meetings earlier in the year, but appropriate action had not been taken. As a result, people, relatives and staff were not consistently assured their feedback, ideas and concerns were listened to and used to drive improvements in care and support or to demonstrate what had changed in response to issues raised.

The provider did not always make sure people could access the care, support and treatment they needed in an environment that promoted independence and wellbeing.

The environment was not consistently designed to support people living with dementia. Dementia-friendly signage was limited, and there was a lack of clocks displaying the date and time to aid orientation. Signage was not always accurate or reflective of the current use of rooms; for example, a room signed as ‘Activities’ was being used for storage, and a shower room was incorrectly signed as a ‘WC’. These issues increased the risk of confusion and may have reduced people's ability to navigate the home independently and confidently.

However, the environment was generally accessible for people with physical disabilities. People were supported to access different areas of the home, including communal rooms helping to promote choice, and independence.

Staff actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff worked effectively with external healthcare professionals to support people to access the care and treatment they needed. One person told us, “I have had the doctor come in here. The [optician] comes round and measures your eyes and sorts your glasses out.” Feedback from visiting healthcare professionals was positive and indicated people’s needs were understood and communicated effectively by staff. One professional told us, “Staff know the residents well, we get no inconsistencies in what we're told and how the person presents.”

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.

The provider's arrangements for planning and recording people's future and end-of-life wishes were not always person-centred or supported by appropriate assessment. We found examples where care records stated people were unwilling to discuss or review their future wishes, including end-of-life preferences, without evidence of decision-specific mental capacity assessments to support these conclusions. Records did not always demonstrate appropriate involvement of those legally authorised to make decisions on a person's behalf where required.

In other cases, care plans contained inconsistent information about people's ability to make decisions while also recording detailed preferences about their future wishes, making it unclear how these views had been established. Additionally, care records had not always been updated promptly to reflect people's deteriorating health needs and end-of-life circumstances. This meant the provider could not be assured that people's wishes for future care and treatment were accurately assessed, regularly reviewed, and planned for in line with their current needs and preferences.

However, records generally contained information relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, and where people's health deteriorated, staff sought advice and support from GPs and other healthcare professionals as appropriate.