Prema Court

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.

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

This service scored 46 (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 treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff felt they had the information needed to support people in a way they wanted and needed. However, information about people current and changing needs were not accurately reflected.

People’s individual needs and wishes were not clearly reflected and acted upon. Information about what people can expect from the service stated people would be supported to achieve independence through education, vocational training and voluntary work experience placements. In addition, the staff team were able to understand people needs, work with them and incorporate their views when making decisions about their care. From our observations and review of records, we found no evidence to support this.

Furthermore, the service no longer used the "Recovery Star" model. This model is used to support people, particularly those with mental health conditions, in their recovery journey.No alternative model was being used to support people. Further training and development were also needed to enhance the knowledge and skills of staff in providing person centred care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

We were told there was good response from the GP with weekly visits to the home. Some people also had a named mental health worker who would visit the service when required. One relative told us there was “Good co-ordination with local health services, the health needs are checked regularly, and they attend regular appointments at the clinic.”

We found care plans needed more detail of the signs of a potential mental health relapse to assist staff in identifying when additional support and referrals to other professionals were needed.

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

Regular reviews of people’s care and support, involving relevant others were not consistently held. Information about people’s current and changing needs were not accurately reflected and there was limited evidence of people’s involvement.

People’s relatives told us communication with the staff was mixed. One relative said they received occasional emails from staff whilst others said they relied on reviews and updates from with social workers

Information for people was not always available in other formats to support their individual communication needs.

The provider did not always make 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.

The information in the brochure from Prema Court explained how families would be involved in their relative’s care and how there would be opportunities to take part in residential meetings and surveys so their views can be listened to.Family members would also be made to feel welcome when visiting the home and feedback questionnaires/would be made readily available to obtain views from family members. Our review of records and comments received did not support this.

We saw resident meetings had been held. Records showed repeated themes were raised by people about the provision of activities and opportunities and meal arrangements. There was no further information to demonstrate this feedback had been listened to and acted upon. Feedback from people’s relatives was mixed about opportunities for them to be involved or share their views. Family members told us, “I would not feel comfortable raising a concern and “There’s a lack of communication and involvement.” Whilst another family member commented, “I feel staff take concerns on board.”

Our review of the provider’s complaints procedures idenitifed it did not provide accurate information to guide people through each stage of the complaints process. The role of the commission was not accurately reflected and details of other agencies to also contact were not provided.

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

People had access to a GP, mental health care teams and drug and alcohol services. However not everyone actively engaged in their appointments. Alternative arrangements had been made for people to attend a local clinic, so they received the treatment they required. We noted one person had not been compliant with their treatment plan. Arrangements had been made for their care co-ordinator to visit the service.

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.

Systems and processes did not evidence how people’s views were sought and acted upon. Where people’s liberty was restricted appropriate arrangements had not been made in a timely way to ensure their rights were protected.

One relative told us they felt the well-being of their family member was well managed and ‘seemed under control’. Another said they were unable to comment as they were not made aware or that reviews and updates were provided by social workers and not staff at the service.

People’s cultural needs were not always met. Whilst one person enjoyed regularly attending church, staff told us people’s cultural diets were not always considered and planned for.

During a recent incident staff had experienced difficulties when trying to access specialist support from external healthcare professionals for someone in crisis. This affected people’s experience and delays in receiving the specialist care and treatment needed.

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.

Not everyone wanted to discuss their wishes at the end of their life. Records seen provided limited information about how staff would support them.

Training records showed end of life training was only completed by senior support workers, support staff were not required to complete end of life training. This meant staff may not by equipped to support people in a way they wanted and needed.