Pilgrims Way Care Home with Nursing

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 legal regulation in relation to person centred care.

This service scored 50 (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.

There was a new deputy manager in post. They told us they had been recruited to update the care plans and would be promoting person centred care at the service. However, at the time of the inspection people’s care plans were generic in places. For example, one person is woken at 2am, turned and continence pads checked. However, there is nothing in their care plan to indicate why this is needed. Care plans include generic statements rather than information about people and their direct care needs. For example, one person’s care plan stated they needed full support with personal care but did not include any information on how that person liked to be supported.

Relatives told us they were involved in reviews of people’s care when appropriate. For example, when people’s needs changed.

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.

People and their relatives told us there was some consistency in the staff team. One relative told us, “There is a consistency, we do see the same faces, we get to know them and they know [my relative] very well, they do know [their] needs, there seems to be a lot of people on all the time.

There was a high level of agency use at the service, particularly during the holidays. The registered manager told us, “If I can’t find the right staff, I would much rather use agency to fill the gaps, they have been coming here a long time.”

However, care plans needed to be improved, and this meant there was a risk new staff would not have the information they needed about people.

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

There was information available to people in various formats. There were notice boards around the service which had information on them for people. For example, what activities were being planned and what was on the menu for the day. However, the activities we saw did not match those planned.

People had communication plans in place. However, these were limited. For example, one person’s care plan included that they were able to understand verbal communication but there was no information on if they could read written information or if they needed larger font and so on. Another person’s communication plan directed staff to speak with the person’s next of kin and provided no information on what the person could understand.

There were systems in place for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, there were repeated complaints about some areas, and it was not clear complaints had been fully investigated.

There were systems in place for people to feedback. For example, one relative told us, “We were sent a survey not long after [my relative] moved there and I think there’s a suggestion box in the foyer.”

There was a complaint policy and a complaint process in place. However, we were not assured complaints were always used to lead effective change. One complaint raised concerns over how call bells were responded to. The outcome did not highlight there were concerns found during the investigation. However, we identified similar concerns during the inspection.

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

Feedback from health and social care professionals was, in the main, positive. One professional was happy with the working relationship with staff and in particular clinic staff. They told us, ‘Care home staff demonstrate excellent clinical reasoning skills.” However, we did identify one person who should have been referred for support with constipation and was not. One health and social care professional told us, “Referrals received are generally appropriate and submitted in a timely manner. However, there are occasional delays.”

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.

There was a lack of signage in the building to support people living with dementia and enable easier navigation. People’s doors did have signs as did showers and toilets. However, the service was set out over 2 large, interconnected buildings, the main house and the coach house, and there were no signs of direction. There was no clear zone markers such as décor changes or such to assist people to orientate themselves and move about the space.

There was sufficient space for people to move about the service, including people who used wheelchairs. There was a lift to support people to access the upper floor. People had access to walk in showers and appropriate equipment to provide them with support.

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.

End of life care plans were lacking in detail about people and their wishes. Some people’s care plans contained limited information, others had more detail, however, the information was generic and not specific to the person. For example, one person’s plan instructed staff to support the person with their wishes and preferences but there was no information on what those were. Staff had not all received training in end-of-life care.

However, the service did work in partnership with the hospice team to provide support to people at the end of their life.