Wolfe House Care Home

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 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 their individual needs.

Opportunities to engage in a range of meaningful activities were limited and did not reflect people’s past interests. One person told us they were often bored. They told us, “If there’s nothing I want to watch [on the television] I just sit here. I get fed-up with it.” Relatives told us they felt there could be more activities for their family members to enjoy. Comments included, “They have things [activities] happening, but it could be better for [relative]. They don’t go out” And “They could do more and have more stimulation.”

The activity schedule was repetitive with repeated chair exercises, bingo and different games. Activities were short in duration and people’s experience such as if they were able to see the activity and understand what was happening was not fully considered by staff. We observed many people sitting in the lounge spent much of the day between meals sleeping and not engaged in what was happening around them. When staff were sat in the lounge alongside people there was a lack of interaction and conversation.

Care staff were responsible for facilitating activities. However, they had only received a brief 30-minute eLearning training session in relation to this. The registered manager told us they would explore different training courses for staff to support them in developing their skills in this area.

Entertainers and external activities were periodically planned in the home such as a singer and visits from animals. Annual celebrations and events were marked such as Christmas, Easter and Halloween.We observed some individual instances where personalised information was used to support people. For example, 1 person was at high risk of falls. Their family member had recommended the person have access to paper they could tear as this was reminiscent of their previous occupation which involved working in an office. This access to paper helped the person to manage their anxiety and their need to mobilise which reduced the risk of falls.

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.

Relatives told us they appreciated the staff continuity and felt this meant a lot to their family member. The registered manager told us that as far as possible they did not use agency staff, but when this was needed, they used regular agency staff who knew the service and people’s needs.

Staff worked alongside a range of professionals to co-ordinate people’s care. We received positive feedback from a professional involved in the planning and provision of 1 person’s care where a number of different agencies were involved. In addition, we saw a thank you message for the contribution and planning the service had put into attending 1 person’s review with a range of professionals. This demonstrated the service worked in partnership to ensure people received consistent and co-ordinated support.

The provider did not always supply information in formats that were tailored to individual needs.

There was a lack of signage around the home to help orientate people living with dementia. Whilst this was understandable in areas undergoing building works, this had not been considered for other areas which were unaffected by this. The names on people’s rooms were small and there was no other signage or objects of reference to support people in recognising their room. In addition, consideration had not been given to how information was shared such as the activities notice board was handwritten with no pictorial reference. This covered a month of activities which made it difficult for people to recognise what activities were planned. The notice board was displayed in an area of the home which the majority of people would not access on a regular basis.

Menu plans were displayed in the dining area and contained pictures of the options available. Whilst these were not displayed during our visit due to the room being decorated, the registered manager forwarded evidence these were normally available to support people in making choices.

People’s care plans contained information regarding their communications needs and the support they required in this area. This included ways in which staff should anticipate people’s needs based on past preferences, body language and gestures. Staff we spoke with were aware of people’s individual communication plans and how best to support them in making decisions.

The provider made it easy for people to share feedback and ideas, and raise complaints about their care, treatment and support. However, issues raised were not always fully actioned to ensure changes were embedded into practice.

Systems were in place to enable people and relatives to raise concerns or highlight areas where they felt improvements could be made. These included surveys of people’s views, a suggestion box and occasional resident and relatives’ meetings. Whilst records showed comments were reviewed and acknowledged, they were not always responded to promptly to ensure issues were addressed. For example, comments had been made anonymously and within the relative’s survey in relation to the overall appearance and cleanliness of the home and the activities available to people. However, we found action had not been taken to resolve these issues and the same concerns were identified during our assessment.

In other areas we found the registered manager responded well to any concerns specific to individuals. Relatives told us they felt they would be able to raise any concerns. One relative told us, “I have a good relationship with the manager, and I feel she would deal with it if I needed to

raise anything.”

The provider had a complaints policy in place which set out how a complaint could be raised and expectations regarding how this would be responded to. Whilst the service had not received any specific complaints, the registered manager fully reviewed and investigated any comments made in relation to people’s care. This meant that issues could be resolved promptly and did not escalate.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The extension which was reaching completion at the time of our assessment had been planned with consideration of the needs of people living with dementia and mobility issues. This created additional space for people in shared areas of the home. The registered manager told us this would enable people to sit in different rooms should they want a quieter environment or somewhere to do a specific activity. In addition, the design would give people more space to sit outside during the warmer months.

People’s physical needs and the support they required was highlighted within care plans. Adaptations within the home such as a lift, stairlift, handrails and an adapted bath/shower room meant people were able to access all areas of the home. The registered manager told us that further adaptations were planned to fit an accessible shower room upstairs for those who did not have en-suite facilities.

People had access to healthcare support within their home from visiting healthcare professionals such as the GP, community nursing team, opticians and chiropody. The registered manager told us additional support was provided to accompany people to hospital appointments where 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.

People’s experience of the support they received was not always holistically reviewed and considered. For example, the impact of the building work had not been fully considered during the planning, particularly for those who were unable to voice their discomfort. A risk assessment had been completed which included how people would be supported during this time. This stated additional opportunities to go out would be planned to help minimise disruption. However, with the exception of people going out with their relatives, no trips had taken place during this time.

Staff had completed equality and diversity training, and assessments of people’s needs considered protected characteristics such as people’s religious and cultural needs, disabilities and gender. Staff advocated well for people to ensure they received the health care they required to support their needs.

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’s care records contained basic information regarding the support they wished to receive at the end of their life. However, there was a lack of personalised detail regarding people’s wishes and what they felt was important at this time. The registered manager told us they would review this information and look at ways of approaching people and relatives to discuss this further.

Staff had received training in supporting people at the end of their life. Where people required medicines to help them remain pain free, this was available in advance through discussions with the GP. Support was available from the community nursing team where more complex support was required to keep people comfortable.