Newton Hall Residential 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 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 54 (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 were not always detailed to demonstrate how person-centred care was being delivered in line with people’s personalised preferences and needs. Staff met people’s individual needs relating to their direct, day-to-day support. However, staff did not always support people to develop their individual skills, to identify goals, aspirations and to work towards them.

People’s care plans did not always contain specific risk assessments relating to diabetes management or mental health risks. Some care plans were lacking detail about how people’s risks were being met, and the support they needed. Some people’s care plans contained generic information which was not specific to them.

Observations showed staff knew people well and were familiar with their individual needs. However, there were gaps in staff knowledge and understanding in some areas, including the principles of depriving people of their liberty and how to effectively involve people in decision-making about their care and support. This meant staff did not always have sufficient information or understanding to ensure these aspects of people's care were consistently addressed.

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.

Although staff knew people well, which helped to reduce the impact of incomplete or inconsistent information within care plans, there remained a risk t people may not receive consistent care and support. This was particularly relevant in relation to personal care and supporting people to maintain their independence.

We found referrals were not always made in a timely manner or to the appropriate healthcare professionals. As a result, specialist advice and guidance were not always readily available, particularly in relation to diet modification and the management of self-neglect risks. This could place people at increased risk of harm and may affect the continuity and effectiveness of their care and support.

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

No significant concerns were raised by people or their relatives in relation to communication; however, people fed back to us they were unaware they had a care plan or records relating to their care or treatment.

Relatives mostly felt information was shared as needed. One relative said, “They will call me if there is anything important, but I can’t remember if I have been asked to contribute to [Name] care plan.”

We observed people did not have pictorial menus to choose what they would like to eat, we were told, people were offered 2 options and they presented this visually during mealtimes however, one person told us they often did not know what was on the menu until mealtimes and they would prefer to know the day or morning before the meals so they can make a choices.

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.

We were informed a management decision had been made regarding the use of small face cloths without consulting all those affected about their preferences. Management had removed face cloths from people’s bedrooms and replaced them with disposable wipes. We found there had been limited consultation and involvement of people in this decision-making process. We raised our concerns with management, who acknowledged the issue and advised they would take steps to address and rectify the situation.

People and their relatives were provided with feedback surveys. While the responses were mostly positive, one relative raised a concern they had needed to remind staff about their loved one’s personal care needs, which were not always being met appropriately. There was limited evidence to demonstrate this feedback had been acted upon. Management informed us they were not aware of any concerns or complaints having been received. As a result, the registered manager was unable to clearly demonstrate how feedback was used to drive service improvements, inform development, and achieve better outcomes for people.

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

The home environment was not fully accessible or inclusive for all people living at the service. While staff supported people to move around the home, we observed some individuals predominantly used the upstairs lounge and were separated from others, resulting in limited opportunities for social interaction and engagement.

For example, we observed one person spending significant periods of time alone in the upstairs lounge, with minimal interaction from staff or other people living at the service. When we spoke with the person about engaging with others, they told us they had become accustomed to spending time on their own in the upstairs lounge.

We discussed with staff whether alternative approaches had been considered to support the person to engage more fully in social activities and interactions. Staff explained the person experienced mental health needs and remained in the upstairs lounge to avoid causing disruption to other people. We were not assured opportunities to promote inclusion, meaningful engagement, and social interaction had not been fully explored.

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.

Not everyone received care and support that promoted equality or consistently met their individual needs. Although staff knew people well and treated them with respect, they did not always have the information or knowledge required to support people's specific needs effectively.

For example, we observed one person who predominantly remained in their bedroom. Their room had a strong malodorous smell, and their personal hygiene required attention. When this was raised with management, we were informed the person routinely declined care and support. However, there was limited evidence alternative approaches had been explored to promote the person's dignity, wellbeing, and personal hygiene needs. As a result, the person's living environment and personal care needs were not being adequately addressed, which placed them at risk of experiencing undignified care and a reduced quality of life.

People were treated fairly and with dignity, regardless of their individual circumstances or protected characteristics.

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 the time of our assessment, no one was receiving end-of-life care. People were offered opportunities to discuss and plan their future care wishes, including their preferences for end-of-life care, although some chose not to engage in these discussions when they first moved into the service.

We reviewed examples of end-of-life care plans, which reflected people’s individual wishes, preferences, and what was important to them. Staff told us they supported people to remain at the service at the end of their lives where this was their expressed choice and appropriate care could be provided. This approach helped ensure people’s wishes were respected and supported them to receive dignified, compassionate, and person-centred care at the end of their lives.