Nevin House

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 remained/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, treatment and choices and they did not always work in partnership with people to decide how to respond to any relevant changes in people’s needs. Care plans did not show people were involved in their care or that any possible communication support methods which would enable people to participate in decisions relating to their care were used. While families were informed of any changes to care plans, there was no evidence that reviews of care plan’s involved other professionals associated with people’s care such as Diabetic Nurse, SALT or Chiropodist.

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. Staff had a good understanding of people’s individual needs. The interim Manager had recently been working with the local authority for funding one person with their 1 to 1 care needs. One relative told us, “I’m happy about where [they are]. Me and [their] mum are content because at last [they’re] in the place [they] should be”. Staff were consistent which provided people with continuity of care. However, staff had not undertaken relevant training around learning disability awareness to enable them to understand and fully meet the needs of the people using the service.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The Accessible Information Standard (AIS) is a legal requirement for all organisations providing NHS or publicly funded Adult Social Care. It states providers must make sure people who have a disability, impairment or sensory loss are able to access the information they need in a format they can understand. There were no adjustments in relation to people’s care plans to enable them to understand about their care. There was also no input from external professionals regarding best ways of supporting and promoting communication for two people at Nevin House. One person’s care plan recognised that their signals to communicate ‘are not always clear’ and stated all staff should be familiar with the person’s unique communication style within a week. However, one person used sign language and Makaton to communicate and staff had not been trained in either of these communication styles. This placed people at risk of not being supported to make their needs known and met.

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 were not always given the opportunity to share their feedback or to raise concerns or complaints about their care. Relatives told us they knew how to complain and who to complain to and they were asked for their feedback and opinions via a survey. One relative told us their loved one ‘had daycare’. However, we were informed by the interim manager that no people living at Nevin House attended day care or day services any longer. This would indicate that relatives were not always in reviews of their family member’s care.

The provider made sure people could access the care, support and treatment they needed when they needed it. Staff ensured people had equal access to care and treatment, so people did not experience discrimination because of their disability and individual needs. For example, staff ensured a person’s relative was informed of any up and coming appointments so they could attend these appointments with the person to minimise their anxieties and enable their access to healthcare. Relatives told us that they knew who to contact in an emergency and staff stated they were able to call the manager out of hours if required.

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. Staff had an understanding of the needs of the people they supported including their cultural needs. However, staff had not received training in supporting people with a learning disabilities and autistic people to understand, recognise and raise any concerns relating to inequalities faced by people they care for. We observed people being disempowered by staff immediately answering for them. This was a missed opportunity to explore solutions to minimising barriers and promoting better outcomes for people.

People were not 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. People were not involved in reviewing their care plans. People’s future was not discussed with them or their relatives and care plans did not include goals, aspirations or plans about future care. This placed people at risk of not receiving care in line with their wishes.