Agnes Court - Care Home with Nursing Physical Disabilities

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 57 (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 records did not fully reflect people’s individual aspirations, goals or desired outcomes. Where people had identified goals relating to independence, community engagement, volunteering, relationships and money management, care plans lacked clear action plans, measurable outcomes and review processes to demonstrate how progress would be supported and monitored. Daily records were predominantly task-focused and did not consistently evidence how staff were supporting people to work towards their personal goals or develop greater independence. This was reflected in people’s experiences, with some reporting limited opportunities to access the community, pursue interests or spend time in ways they chose due to staffing constraints. Not all people and relatives felt involved in the planning of people’s personalised care. One relative said, “We get notified when the care plan is due for review.” Another relative told us, “I have no idea what a care plan is and I’m the one they would consult with.” This meant the provider could not always demonstrate that care was fully person-centred or focused on helping people achieve outcomes that mattered 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.

Care was joined-up and responsive to people's needs. Staff worked effectively with a range of health and social care professionals and care records reflected professional guidance and showed referrals were made when people's needs changed. Information was shared appropriately between nursing and care staff, helping to maintain continuity of care.

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

Information was displayed around the home in pictorial formats to assist people’s understanding. People’s care plans contained details of their preferred communication methods and we saw staff communicating with people effectively. For example, we observed staff supporting one person to communicate using a letter board, with staff responding in writing to ensure effective two-way communication.

The provider made 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.

Communication between relatives and staff was not always effective. Some relatives told us they did not know who their family member’s key worker was and were not informed when key workers changed. A relative said, “[Name] key carer changes so often, we never know who it is.” Another relative said, “[Person’s] key worker keeps changing which we find frustrating.” This meant leaders did not always ensure effective communication and partnership working with relatives and representatives involved in people's care.

People living at the service had opportunities to provide feedback to staff and leaders through regular residents’ meetings. People and their relatives knew how to raise concerns or make complaints and felt confident they would be listened to. The provider had a complaints process in place and this was understood by the registered manager.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People were generally able to access and use the service, and we observed people moving freely around the home. However, improvements were needed to ensure the environment fully promoted equitable access and independence for people with physical disabilities. Adaptations to the premises had not always been considered to maximise people's ability to access all areas safely and independently. For example, the garden door leading back into the building did not have a handle or automatic opening mechanism, creating a barrier for some people and potentially limiting their ability to move between indoor and outdoor spaces without staff support. This meant the provider had not always considered or implemented reasonable adjustments to maximise people's independence and ensure equitable access to all areas of the service.

Staff and leaders did not always actively listened 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.

People did not always experience equitable opportunities to access activities, community involvement and personalised support. Some relatives told us people received fewer opportunities than others. One relative told us, “Sometimes [person’s] not gone out in over a week, some others (people) go out more than [person] does.” Care plans contained information about people's interests, preferences and sensory needs. However, records did not always demonstrate how staff used this information to tailor activities, promote community participation or ensure people had equal opportunities to achieve their personal goals and aspirations. This meant the provider could not fully demonstrate they were meeting the principles of Right Support, Right Care, Right Culture, which promotes personalised support, choice, control and equitable opportunities for people to lead fulfilling lives.

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. Records did not demonstrate how staff were supporting people to achieve future goals and aspirations. Care plans were focused primarily on people's current risks and care and support needs and did not evidence long-term planning that reflected people’s wishes, including at the end of their life. This meant the provider could not always demonstrate that people were supported to plan for their future or achieve outcomes that reflected their wishes.