Fryers House - 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

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.

The service was in breach of legal regulation in relation to person-centred care.

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 choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Whilst people spoke positively about the activities they were supported to access, they noted a reduction in the opportunities available to engage in activities outside of the service. One person told us, “People haven’t been going out much ... there are some people who haven’t been out for months.” This concern was supported in the feedback from some relatives and staff, who expressed concerns about a decline in people’s quality of life, particularly in relation to reduced access to meaningful activities, limited engagement with the local community, and inconsistent support to maintain or promote independence. Comments from relatives included, “They used to have excursions, but they don’t anymore, and we used to get updates about that, but that has not happened”, “Now, she doesn’t go out” and “They are not giving her any activities.”

These concerns were reflected in our observations during the assessment and in care records. We observed few activities taking place and noted missed opportunities for meaningful interaction and engagement. Care plans did not consistently reflect people’s physical, emotional, social, or cultural preferences in sufficient detail, and there was limited evidence of regular involvement from people or their representatives in reviewing and updating care arrangements. The service did not consistently uphold the principles of person-centred care, and opportunities to tailor support around individual needs and preferences were missed. Therefore, we were not assured people received truly individualised care.

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.People were supported to access health and social care services and had access to the information they needed about these.

Staff worked with other professionals involved in people’s care. This included GPs, social workers and mental health services.

The manager demonstrated an awareness of inequalities in accessing healthcare services and emphasised the importance of a holistic approach to care. They ensured that support was not narrowly focused on a single health condition. For example, when supporting individuals with acquired brain injuries, staff did not assume all care and support needs were solely related to the brain injury. Instead, they considered the wider context of each person’s physical, emotional, and social needs.

The provider had not always ensured that personal information was consistently stored in a way that upheld people's rights to privacy, safety, and informed choice. We identified concerns regarding the safe and secure handling of personal information. During our onsite visits, we observed instances where areas containing confidential and sensitive personal information were found unlocked when not in use, despite requiring secure storage.

Although the provider took action to address these concerns, including installing a new lock for one area, we observed repeated instances of these issues across multiple days. This increased the risk that personal information was not always stored or shared in a way that met data protection legislation or supported people’s rights to privacy and confidentiality. It also raised concerns that such practices may be embedded within the home’s routine, and that sustained change would require time and consistent reinforcement.

People confirmed that they had been asked about their preferred methods of communication and were supported to access information in alternative formats when required. The provider utilised a range of communication methods and created opportunities for people to share feedback and express their views. For example, posters displaying QR codes enabled people to provide feedback easily and independently.

However, some relatives told us that communication from the provider was not always timely. They reported that they were not consistently provided with information, updates, or responses, and felt this could be improved. We have reported on this in more detail under the quality statements ‘Listening to people’ and ‘Safeguarding’.

The provider had systems and processes in place to enable people to share feedback, raise concerns, or make complaints about their care, treatment, and support. However, these were not always effective.

People and relatives generally expressed confidence in raising concerns with staff and the provider. Prior to the assessment, people and relatives noted a decline in responsiveness and follow-up. They told us they were not consistently kept informed, updated, or provided with outcomes. Some relatives described having to repeat information and expressed uncertainty that action would be taken. They told us the response depended on who they had spoken to, and described having to monitor and escalate concerns more than once to ensure they were addressed.

Concerns were also raised about poor handover of information between staff, which contributed to uncertainty about whether issues would be resolved or changes communicated and acted upon. Records reviewed supported this feedback; we found examples of incomplete complaint documentation, likely affected by changes in management that may have disrupted oversight and continuity in the complaints process.

There was a consensus among people and relatives that there had been some improvement since the new manager assumed day-to-day leadership of the service. People and relatives knew who the manager was and described them as approachable and accessible.

Leaders demonstrated an understanding of the importance of effective communication and showed a commitment to openness, transparency, and improving engagement. Their planned approach to fostering positive engagement included actions aimed at improving feedback mechanisms and promoting person-centred care. These included, displaying posters with QR codes to facilitate easy access to feedback, senior management audits involving direct conversations with people to gather their views, and introducing a ‘resident of the day’ initiative to centre care and attention around the person.

The provider ensured that people could access the care, support, and treatment they needed, when they needed it. Discussions with the manager demonstrated a clear understanding of how to access specialist health and social care services, including referrals to external professionals such as speech and language therapists (SALT), when required.

Arrangements were in place to ensure staff had access to support during emergencies, even when a member of the leadership team was not on site. This included a clear on-call rota and established emergency protocols. In response to recent challenges, the manager had offered additional short-term support beyond the formal rota, making themselves available and accessible to staff to support continuity and provide reassurance.

These actions reflected a proactive approach to maintaining access and responsiveness, particularly during periods of operational pressure. However, while these arrangements promoted responsiveness to people’s support needs, further evaluation of how the service identifies and removes barriers for those at greater risk of unequal access, such as individuals with communication needs, disabilities, or protected characteristics, would strengthen assurance that equity is consistently upheld. Shortfalls relating to these areas have been explored in more detail elsewhere in this report.

Due to shortfalls identified in care records, daily documentation, risk management, and the delivery of care in line with assessed needs, we could not be assured that the provider consistently tailored care and support to individuals. These gaps increased the risk that the service could not consistently or effectively identify or respond to the needs of people most likely to experience inequality in outcomes.

Although leaders and staff demonstrated a commitment to supporting people’s rights and wellbeing, the lack of consistent, person-centred planning and delivery limited the provider’s ability to remove barriers, promote equity, and protect people’s rights in practice.

The provider had systems and processes in place to support people in planning for important life changes, including end-of-life care. This enabled people to make informed decisions about their future.

Where people had expressed preferences for their care at the end of life, these were documented in their care planning records. This included details about their preferred place of care, as well as their cultural, spiritual, and personal wishes. Where appropriate, loved ones were involved in planning discussions, helping to ensure decisions reflected what mattered most to the person.