Abbey Ravenscroft Park Nursing 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 service met people’s needs.

At our last inspection we rated this key question requires improvement.The provider was previously in breach of the legal regulation in relation to personal care. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

At this inspection the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

At our last inspection we found people’s care plans were not always accurate or up to date. Some plans did not provide sufficient guidance or detail on how to provide person-centred care to them. People receiving 1 to 1 care were not supported proactively and people who expressed dementia related distress were not being supported in ways to try and reduce this distress.

We found improvements at this inspection. Staff worked with people to develop a personalised care plan with them which took into consideration their needs, risks and desired outcomes following an assessment. Care plans were more detailed and contained information about people’s preferences, likes and dislikes, and included equality and diversity information. Care plans for people receiving 1 to 1 care contained guidance on how to engage and support them throughout the day. People’s views, opinions and choices were interpreted into plans, so they were in control of their own lives. People that could experience dementia related distress had plans in place to help mitigate this. Staff told us the guidance helped them to reassure people and maintain their wellbeing.

The provider had made efforts to make people’s care more personalised and meaningful. People were able to personalise their rooms with decorative pieces and family photographs. Memory boxes, which helped people with dementia, were placed near their front door containing items that were important to them from their past. People had named key workers who were members of care staff assigned to support them and get to know them. Pictures of people’s assigned key workers were on each person’s wall with details about both the key worker and person so that both could engage in easy conversation. This helped staff understand people’s histories, interests and passions and they could develop ways to support people in a more person-centred way. For example, a person was treated to a special birthday party attended by their friends and family. The party had a theme relevant to the person’s cultural background and feedback we viewed showed that the relatives really appreciated this.

People told us they were happy with the way care was provided but some along with their relatives told us they had not been able to read their care plans. A relative said, “I don’t think I have seen [family member’s] care plan.” Another relative told us, “The initial meeting was methodical when [family member] moved in but I am not sure if we saw the care plan.”At the time of our inspection care plans were in a digital format and we asked the management team how people and their relatives were able to access them. They told us access to the system was given to people from the outset and this was discussed with them and their relatives, so that they could agree the best format for them, for example log in details or paper copies. However, people and relatives we spoke with told us they had not been offered this. The manager told us they would contact people and relatives to ensure they were able to access the care plans if they would like to.

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 management team was mindful of people’s needs and feelings and took steps to ensure that people received continuity of care to help them integrate into the home. People told us about how well they got on with staff. Staff were able to reassure and support people when they became distressed or angry and resolve incidents to keep people safe. They communicated with relatives to inform them of any incidents.People told us they received care and support from staff they were familiar with and there was consistency and continuity in the service. The management team understood people’s health and care needs and communicated with professionals so people could have access to local health services.

The home employed activity staff to arrange various activities for people to participate in. During the morning of our visit we saw the activity coordinator had arranged a flower arranging session for people. The coordinator encouraged people and made efforts to include everyone, despite some people not physically able to take part. We saw that that fresh flowers were used, which allowed people to enjoy the scent of the flowers and engage their senses. After the flower arranging activity, there was a singing session in the afternoon and staff made efforts to involve people. A professional singer also attended and staff encouraged people to sing and dance if they wished to. The provider had recently recruited a second activity coordinator, and in the afternoon, we observed them going up to the second floor to lead the same activities with people there. This showed the provider was involving people in the day to day activities and entertainment in the home. A relative commented, “From what I have seen there are plenty of activities for the residents.” An activity plan showed the week’s events that were taking place each day such as bingo, musicals, painting, park outings and memory games. People could choose to participate if they wished.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were assessed and discussed during their initial assessment. This ensured staff knew how to communicate with people appropriately. The provider understood the requirements of the Accessible Information Standard. People’s preferred communication style was used so they could take part in reviews of their care. This enabled people to have their views, opinions and feedback captured and acted on. Communication tools were tailored to people and available to them to enable them to express their views, wishes and to make decisions. Staff were available to communicate with people in their preferred first language, for example if they had similar cultural backgrounds. Staff told us they knew how to communicate with people appropriately and respectfully and in accordance with their needs. The provider was able to give out information in formats that were easy to understand such as easy read or large print versions of complaints forms or newsletters.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People told us they felt free to raise any issues with their keyworker, or the manager. They felt confident they would be listened to and action would be taken to resolve any issues. A relative said, “We have not made a complaint. There have been a few niggles, but they got it sorted very quickly."

Complaints were handled appropriately and a relative was positive about the service and the level of communication and responding to concerns. They said, “Since the new management there have been some improvements.” However, some relatives we spoke with told us they did not always hear back from the management team when they raised an issue. Comments from people and relatives included, “Communication could be better” and “I am not sure who the manager is.” We brought these concerns to the attention of the management team who looked into them and ensured they followed up on any outstanding actions and spoke with people and relatives. The manager said, “I will arrange meetings with families and make sure we apologise if communication was missed and to address the matter.” Records showed that action was taken to address people’s concerns, but more effective communication was needed with people and relatives to ensure all issues were resolved and completed satisfactorily.

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

Staff and managers understood the needs of people with dementia or mental health needs. They worked hard to ensure that typical barriers faced by people were removed or mitigated against.Staff were able to access support from the manager out of office hours. They were available on call when needed, for example if there was an incident or emergency. Referrals to specialist services such as speech and language therapy (SALT) and tissue viability nurses (TVN) were completed promptly where there was a change in people’s needs. The service had a good relationship with the local GP service.

Staff and managers followed processes to make sure people continued to have fair and equal access to services such as registration with a GP surgery or dentist. They had regular health checks and health reviews. The provider had a clear ethos for the service based on human rights, anti-discrimination and equity principles, and staff and people who used the service understood these. Staff told us they respected people’s individual equality characteristics such as their gender and religious beliefs.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.The management team told us people were assessed before they used the service to ensure their needs and preferences were identified and could be met. Assessments of people’s diverse needs and equality characteristics were discussed prior to using the service. These included their religious beliefs, disabilities and cultural preferences. People attended external appointments with reasonable adjustments being considered, planned for and communicated. Any disabilities or health conditions they had did not prevent them from accessing prompt care and treatment.

The management team had an awareness of the groups of people who were at risk of inequalities and barriers to their care. Care plans recorded details about each person's specific needs and how they liked to be supported. This meant people were supported to have a positive experience and good outcomes for their care.

People were 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.

At our last inspection we found people’s care plans did not set out their wishes and care preferences should they become seriously ill and require end of life care. There was not always evidence that the service had worked with people and their relatives to inform such planning. There had been improvements and people and their families were involved in decisions about their future care and support.

End of life or palliative care was provided by the service and an end of life care policy was in place. People’s wishes and preferences for example for their funeral arrangements, were recorded and respected. Their cultural and religious beliefs were also taken into account. Where applicable people had DNACPRs (Do Not Attempt Cardiopulmonary Resuscitation) forms in place which had been authorised by their GP.