Sandholme Fold

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.

This service scored 57 (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

Our observations showed a person-centred approach was not always followed by staff. At times, staff spoke about people rather than including them in the discussion, and language used was not always person-centred. For example, staff spoke with one another in people's presence about what care tasks they were doing and described the person as a task whilst they were right beside them. For example, a member of staff said 'she's an assist' meaning the person required support with their meals.

Care documentation varied in evidencing a person-centred approach. Some gave good details about people, their personalities and the support they needed whilst others lacked this information. We saw this was being addressed by the provider.

Some relatives we spoke with said they had been involved in their family member’s care planning whilst others said they had not, despite asking to do this.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service worked with health and social care professionals to make sure people’s needs were met. This included GPs, district nurses, palliative and mental health services. Where care was shared between the service and health care professionals, the person’s care plan included details of how this would be achieved.

The local district nursing team had provided support and guidance for some staff in relation to blood pressure monitoring, blood sugars and use of O2 readers to measure oxygen levels.

We received mixed feedback about whether people and their relatives had seen care plans. The provider told us care plans were not printed and given to people, but they were available to view on request.

There was limited information to show people had access to information in different formats based upon their 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.

Care records did not always indicate the involvement of the person or, where appropriate, their representatives.

Although we saw some good examples of staff interactions, people were not always listened to or involved in matters affecting them. For example, staff presented 1 person with a small meal and told the inspector “[Person] doesn't each much” yet there had been no attempt to ask the person what or how much they wanted to eat.

Meetings were held with people and their relatives and friends. Some relatives told us they had raised issues at previous meetings that had not been addressed.

Systems for managing complaints made to the service required improvement.

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 did not always experience equity in the care provided and there was some disparity in care experiences between people. Where people had their mobility, there was more autonomy for them in their daily routine. Where people relied on staff to help them, opportunities for choice and variety of experiences were limited. People’s protected characteristics and individual differences were not consistently identified, respected, or met, leading to some shortfalls in inclusive, respectful care.

Where people had difficulty communicating, they sometimes were not able to make their needs known. For example, for one person for whom English was not their first language, staff did not have sufficient skills or tools to assist communication. Staff told us the person once had picture cards and resources in their preferred language, such as television programmes, but these had been misplaced and were no longer used or available. Where another person had difficulty speaking clearly, staff did not always take the time to try to understand their needs.

Feedback from relatives was mixed with some reporting better experiences for their family members than others.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

People’s preferences in relation to emergency care and treatment, including resuscitation were documented. End of life care plans were in place. However, care plans had not been developed to detail the support 1 person would need in preparing to move from the service to a more independent living setting.