Wymeswold Manor

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.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 53 (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.

People’s care plans lacked information about their personal preferences and the way they would like to be supported. People’s care plans for support needs such as personal care, living with dementia or health conditions were more generic and lacking in person centred detail. For example, 1 person was known to experience periods of emotional distress. Whilst staff were aware of this, the person's care plan did not contain clear guidance on the signs that may indicate they were becoming distressed, potential triggers, or the actions staff should take to provide reassurance and support.

People gave mixed feedback about their involvement in care planning and reviews of their care. Whilst some people told us staff spoke with them about their needs and preferences, most people were unaware they had a care plan in place and could not recall being involved in its development or review. This meant the provider could not be assured people were consistently supported to contribute to decisions about their care and treatment, or that care plans accurately reflected their wishes, preferences and desired outcomes.

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 demonstrated a good understanding of people's health and care needs and were able to provide relevant information to healthcare professionals to support people's care and treatment. A visiting healthcare professional spoke positively about the service and told us, "When at the residential home communication with staff is effective, they have the information required to aid in diagnosis and they have a really good knowledge of the residents' medications and medical history."

However, the provider could not demonstrate that staff had received training specific to some of the health conditions and care needs of people using the service as detailed within the report. While staff were able to describe people's needs and support requirements, there was limited assurance they had received the specialist training necessary to consistently deliver care in line with current best practice. This increased the risk that staff may not always have the knowledge and skills required to meet people's individual needs effectively.

Therefore, although people generally experienced coordinated care and staff worked well with external professionals, further improvements were needed to ensure staff training reflected the complexity and specific needs of the people they supported.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Communication care plans contained guidance for staff on how best to communicate with people, including any specific communication preferences or support requirements.

The provider had taken steps to ensure information was accessible throughout the service. Pictorial signage was displayed around the home to support people with orientation and independence, helping them to identify key areas of the service and navigate their environment more easily.

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 provider sought feedback from people and their relatives about their care, treatment and support. However, as there were limited action plans arising from mechanisms such as surveys, this meant the provider could not demonstrate they had fully involved people in decisions or told them what had changed as a result, even where they had acted on that feedback. A complaints policy was in place for people to follow if required, and we saw responses were given in line with this policy. Surveys with family members generally showed satisfaction with the service provided. The provider also sought the views of staff. This would benefit from more detailed analysis and action plans to show the action taken in response to suggestions made.

A relative raised concerns with us about the effectiveness of communication within the service, particularly after visits from healthcare professionals. They said they often needed to be proactive and closely involved to ensure their family member received the care and support they needed.

The provider did not always ensure people could access the care, support and treatment they needed at the right time.

Systems for monitoring people's wellbeing were not always effective, as daily care records were not routinely reviewed to identify changes in people's needs, emerging concerns or where additional support may be required. This meant opportunities to recognise and respond to changes in people's health and care needs may have been missed.

However, staff supported people to access healthcare services when required. Records showed referrals were made to relevant healthcare professionals, including GPs, speech and language therapists and district nurses, and people were supported to attend appointments. Healthcare professionals spoke positively about the service's engagement with external agencies. One visiting professional told us, “Excellent follow up from the team when I suggest referral on for any [care] issues I feel need intervention to GP, District Nurses etc.”

Although staff worked effectively with external professionals and supported people to access healthcare services, improvements were needed to ensure information recorded about people's day-to-day wellbeing was consistently reviewed and used to identify when people may require additional care, support or treatment.

Staff were aware of people's individual needs and could describe how they provided person-centred care that reflected people's preferences, backgrounds and what was important to them. Care plans generally contained information about people's life histories and interests, helping staff to understand and support people in a way that respected their individuality.

However, the provider could not demonstrate that most staff had completed equality and diversity training. This meant there was limited assurance staff had received the necessary learning to understand how protected characteristics under the Equality Act 2010 may affect people's experiences and outcomes, or how to identify and challenge discrimination and inequality in practice.

While we found no evidence people were being treated unfairly and staff demonstrated an awareness of people's individual needs, improvements were required to ensure all staff received appropriate equality and diversity training. This would help strengthen staff knowledge and support the delivery of equitable care and positive outcomes for all people using the service.

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.

People had end of life care plans as part of their planed care. However, they were found to be generic and focused on people’s DNACPR (Do-Not-Attempt-Cardiopulmonary-Resuscitation) status and advised staff to maintain privacy and dignity and contact next of kin. There was no person-centred information or guidance for staff such as if they would want to see a leader from their faith, would they want to be admitted to hospital, or if they would find touch comforting.

Records evidenced staff had completed training in end-of-life care, but we were not assured they were competent in advanced care planning.