Radcliffe Manor House

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• 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, people’s safe care and treatment and governance at the service.

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.

The provider did work in partnership with people however, not everyone felt they were at the centre of their care and treatment choices. Not everyone experienced person-centred care at all times. Instead, care was planned around the availability of staff.

Staff did understand how to provide person centred care, but people did not feel that they received such type of care.

We saw that staff were busy supporting people’s physical needs (like going to the toilet). They therefore did not always have time to engage with people on a person-centred level.

Staff used digital devices to record details of the care people received. However, records detailing the support people had received were brief and did not demonstrate that planned care had been consistently provided.

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 received feedback from partner agencies of positive working relationships in response to safeguarding investigations. One person told is, “The doctor will come in if you need attention. I know an optician comes in, or you can go to the one in the village. I had the dentist come in last year to check a bad tooth.”

However, one person expressed concerns regarding integration of care services stating, “The nurse comes to change [their] catheter but [they are] supposed to have antibiotics beforehand as [they] get infections easily, but that doesn’t often happen. I asked for cream a few weeks ago and there’s such poor liaison between the surgery, pharmacy and here.”

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

Staff had received training around management of information. Care plans contained a vast amount of historical needs, meaning that it would be hard for other services to interpret the most current care needs for people. Care plans and details were not always updated in a timely manner, meaning that incorrect information could be shared with visiting professionals or when attending appointments. People and relatives did not always feel information was shared with them in a timely manner, and they were not involved with updating care plans.

Notice boards contained information of upcoming events, as well as maintenance work being carried out. Not all people read these but were still aware of what was taking place.

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.

People we spoke with could recall meetings for residents or relatives, but these appeared to be infrequent. Some felt that issues raised had been listened to and some actions taken. One person told us, “They’ve had a meeting with us every few months I suppose. Someone from the office will chat and ask us how we are.” Another person told us, “They have them twice a year and ask us about food or various questions. We get to see changes. We said we’d like the singer back and animals to come in.” We were also told, regarding activities at Radcliffe Manor House, “I don’t think there’s much on compared to other places I’ve seen. I’ll do bingo or dominoes but though there’s a list of daily things happening, there’s nothing on every day. Sitting around can be boring.”

Some staff, residents and relatives said they felt listened to, whilst others felt that the routine of the home was not led by people’s choices, but by what fitted the service.

The provider made sure that people could access the care, support and treatment they needed when they needed it. We did not identify any concerns in relation to people being able to access external services. However, 1 resident had an issue with their wheelchair size. They told us, ‘I am not comfy in my wheelchair as it’s small, because of the lift size. I used to have one I could push along myself with the big wheels.” This impacted upon the person independence and freedom around the home. The provider did inform CQC that the new wheelchair had been provided by an external Occupational Therapist, however this does not appear to have been conveyed to the person clearly for their understanding.

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People who spent most of their time in their rooms said they experienced delays when requesting support and staff accepted these delays did occur. Feedback on the activities provision was not overly positive, with the lack of activities mentioned by most people. One person told us, “There’s not something on every day, so we have puzzles or box games left out, if you’re able. We sometimes have a singer or bingo and lay workers come from church now and then to chat or do communion.” During the assessment, there were limited activities on offer and care records demonstrated people had not been regularly supported to engage with a range of activities.

Following lunch, we observed a number people being taken into the lounge, without staff or any activities to engage in. People were left in wheelchairs and were around the edges of the room, making it difficult for them to engage with one another.

One resident told us, “We don’t go out unless family take us. We’re going to share a minibus for outings soon, I’d heard. I go in the lounge if it’s exercises or an entertainer or to play scrabble. But I don’t stay if they’re all asleep.”

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. Documents stated if people had a ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) form in place. A ReSPECT form can be used to record wishes and preferences so that in the event of an emergency, decisions about peoples care that reflect their personal wishes. Some people had care plans with their wishes on end-of-life care, however, for others, these lacked detail and information regarding any future arrangements that had already been planned.