Squeaks House Residential 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 the legal regulation in relation to person centred care.

This service scored 46 (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.

Not all people using the service had a plan of care detailing all of their care and support needs and how this was to be delivered by staff. Not all care plans accurately reflected people’s current care needs. Some people’s care plan contained generic information. This meant there was a risk that relevant information was not captured for use by staff to demonstrate appropriate care was being provided and delivered in line with people’s support needs.

ABC records which help identify patterns, for example, triggers relating to how a person’s anxiety and distress presents, and what happens as a result, were poorly completed and did not provide sufficient evidence of staff’s interventions and outcomes.

Some people spoke positively about the care they received and implied staff were responsive to people’s needs. However, as highlighted previously, people’s experience did not always evidence personalised care that met their specific needs. Not all people using the service felt there were enough social activities readily available. On the first day of our assessment, there was a lack of social activities provided at the service. A person using the service told us, “The trouble here is I’ve nothing to do at all. I don’t know anyone here and look I’m just not doing anything here, just sitting. I’m not keen on the atmosphere here to be honest, there is nothing happening.” People who were seated within the main communal lounge were observed to be seated in the same position for most of the day on both days of our assessment.

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

Staff worked with other services and involved people’s relatives to provide care and support to people. People received care from the same staff, so they experienced continuity of care as many members of staff had been employed at the service for some considerable time.

The provider did not always supply appropriate, accurate and up to date information in formats that were tailored to people’s individual needs.

Though people’s communication needs were recorded, the Accessible Information Standard [AIS] was not fully implemented within the service. For example, although an activities programme was displayed within the main communal lounge, a full week’s activities was recorded which some people, particularly those living with dementia, may find it difficult to decipher and understand. Additionally, the information was placed high up, making it hard for people to see clearly what was happening. The menu was not pictorial. The information board in the corridor on the ground floor displayed no information on either day of our assessment. This board could show the date, day of the week and the weather.

Care plans had communication records in place to guide staff on how best to communicate with the person they supported.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The manager told us they encouraged people who used the service, those acting on their behalf and staff to share feedback about the quality of the service provided, and what it was like to work at Squeaks House Residential Care Home. Quality assurance surveys had been forwarded to individuals, inviting them to provide feedback and suggestions for improvement. These were last completed in September 2024, with the majority of responses received being positive. Where areas for improvement were cited, there was an action plan completed detailing how these were to be addressed. However, there was no information recorded to indicate progress and if the actions raised had been completed. The manager stated new quality assurance surveys would be sent out by the end of March 2025.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Discussions with people using the service and those acting on their behalf implied they had not experienced discrimination or inequality. However, care records demonstrated people did not always access services, including emergency healthcare services, including out of normal hours and in an emergency. As previously highlighted a person using the service experienced delays in receiving emergency healthcare.

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.

We identified shortfalls with the services care planning arrangements. This was discussed with the manager as further improvements were required in this area.The manager was receptive to our findings.

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.

Where people were judged to be at the end of their life, there was a lack of detail record within their care plan relating to their decisions about their preferences for end-of-life care. For example, the information provided no specific evidence as to how they wished to be cared for so as to receive a comfortable, dignified and pain-free death.

Where appropriate, ‘Do Not Attempt Cardio-Pulmonary Resuscitation’ [DNACPR] orders were recorded. The service worked in partnership with other professionals, such as the local palliative care team to ensure people received appropriate end of life care. Not all staff had completed end of life care training.