St Bridget's - Care Home 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 inspection we rated this key question outstanding. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met. We identified a breach of the legal regulations.

This service scored 62 (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 make sure people were at the centre of their care and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We observed people in the dining room at lunchtime. Meals were collected by staff from a serving hatch and placed on tables which were wobbly. There were no tablecloths or condiments on the tables. People had to ask for sauces if they wanted these. The atmosphere in the dining room was noisy and hectic, with no opportunity for people to socialise or communicate with each other.

During the medicines round, a person asked the staff member giving them their medicine if they could help them to blow their nose. The staff member refused and said, “No, because I’m in the middle of a medicines round, I’ll get someone else to help you.” We fed this back to the registered manager who later told us the staff member was nervous about being observed.

We spoke with 1 person who was eating their supper in their nightclothes at 6.30pm. When we asked them if they chose to get ready for bed at this time they told us, “Yes, I choose to. It can’t be later because I don’t know how long I would need to wait, so I get changed early.”

Parts of care plans we reviewed were not person-centred and information about people appeared to be generated in a way that was not personalised. The provider told us this was due to the electronic care planning system in use at the time. This system has now been replaced with another. However, 1 person had a progressive health condition, but there was no information or guidance about this for staff to refer to in their care plan.

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

People had access to a range of healthcare professionals and received co-ordinated care and support. For example, 1 person was at high risk of choking, so they were given a modified diet, as recommended by a speech and language therapist, to reduce this risk. People were supported with their oral care through regular visits to their dentist, and for foot care with a podiatrist.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailed to individual needs.

Information within people’s care plans was not provided in an easy-read or accessible format that met people’s individual needs and preferences. Information on display around the home was not provided in an accessible way. For example, we read a notice outside the dining room which stated that the menu had to be changed, ‘due to supply issues’ which had resulted in people not having a choice of main meal.

The provider had a policy on supporting people’s communication and sensory needs. This stated, ‘The service ensures that information about the service user’s support is provided in a format and in a way that encourages the service user to be informed and involved as possible in decisions that affect their life.’ In addition to information within care plans not being provided in this way, minutes of residents’ meetings did not provide information in an accessible or understandable format. Against items that had been discussed, no actions were recorded, so people would have struggled to see whether their suggestions and ideas had been listened to.

The provider made it easy for people to share feedback and ideas or raise complaints about their care and support.

A relative said, “If we were worried about anything we would talk to the carers, or to someone in the office.” A person told us, “I do tell [registered manager] if I have a problem and he will talk to me in private; I can go to a team leader as well.”

Complaints and any lessons learned as a result were logged on the provider’s system.

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

People’s care and support was accessible, timely and in line with best practice and legal requirements. People had access to on-site physiotherapy and occupational therapy professionals, and support from external agencies when needed.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experiences and outcomes. However, some people did experience inequality in experience or outcomes due to the way their care and support was funded. For example, a relative told us, “[Person] does not get any 1:1 support, we keep trying with the authority. A staff member asked me to stay on for a bit so I could help [person] have a bath because it’s hard for staff to find time.”

Staff told us, “Leonard Cheshire’s vision was to give people independence and make sure they were treated as equals, not judged for their disability. We do try, but some of it is linked to funding and some people don’t want to do group activities.”

People were 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.

A relative told us their family member had been able to access a live-stream of their loved one’s funeral, which meant they could be involved without having the stress of attending in person. Another relative stated, ‘I never had any concerns about [person] being at St Bridget’s, knowing that she was always loved and completely safe in your hands, given the best care imaginable, we will always be grateful.’

Care plans included how people wished to be cared for in their final days. Some people had Recommended Summary Plans for Emergency Care and Treatment (ReSPECT). These focus on people’s individual needs and preferences and included advice in an emergency situation when a person may be unable to communicate, such as during cardiac arrest.