Wray Park 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.

This is the first assessment for this newly registered- amend as required service. This key question has been rated 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 50 (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 did not always receive person centred care and support. The service environment did not lend itself to supporting people living with dementia. Dementia-friendly environments use clear signage, color-coded areas, and distinct, simple layouts to help people living with dementia find their own way around. We found this was not in place.

There was a lack of information in people’s care plans around their preferred routines. This included when they preferred to go to bed and get up and what comforts they wanted with them at night. We also noted there was no information in people’s care plans around their life history despite People had limited information about their life history and backgrounds. Staff did not always have knowledge of people’s past lives. Where this information was collected it was stored away from the main care and support plans. It is important to understand where people came from and their experiences of life where possible in order to provide good person-centred care.However, one person told us, “They [staff] know me as a person, and they know how I want to be cared for.” We found that people were able to personalise their rooms with ornaments, photos and furnishings.
 

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.

Care plans lacked information around how frequently people needed to be repositioned or checked on in their rooms. There were differing responses from staff on how frequently this needed to be done. One member of staff told us, they check people, “If you are passing. And people have sensor lights.” Also, information was not being accurately shared with the kitchen staff on peoples required modified diets. The registered manager told us 2 people required a soft meal and 3 required a pureed meal. However, the information on the board in the kitchen had differing information around people’s modified meals. The registered manager told us it was leaders’ responsibility to update the kitchen with the accurate information and that on this occasion this had not happened.

However, we found the staff communication book evidenced people received consistent care across different settings and from different healthcare professionals. This included with their GP and community nursing teams. It would have benefitted leaders to update people’s care plans with the detail around these visits and communication with other professionals. One external professional told us, “The staff will also actively follow-up any instructions that I may leave in terms of the follow-up care of residents.”

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

The leaders had not used various alternative communication aids for people with a cognitive impairment including dementia. There was no dementia friendly signage to orientate people including to the toilet, bathrooms and people’s bedrooms. There was no dementia friendly information in the lounge to remind people of what day it was and the time. The menus were not in picture format, and staff were not offering a visual display of meals to people during lunch. This meant some people were being excluded from making decisions and exploring opportunities to be independent.

However, other people and relatives fed back that communication with the service was good. The registered manager told us, “Most of the information, I can make it in larger fonts and things like that.”

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.

Leaders had not always ensured that people with a cognitive impairment were able to share their views. We saw the provider organised residents’ meetings; however, these were not attended by many people. There had been a lack of consideration into how people’s views could be gained such as one-to-one meetings.

However other people, relatives and stakeholders that were able were asked for feedback via surveys. We saw where complaints had been received, these were investigated by the registered manager and changes made where necessary. One person told us, “I would speak up if I had any concerns.”

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

We found access to activities was not always equitable particularly for those cared for in bed. Records evidenced people had access to a range of external professionals, such as nurses, representatives and GPs. However, we could not be assured staff always followed their advice due to concerns we found during this assessment.

People who were able to speak up about their needs received a more flexible approach therefore demonstrating not everyone had the same opportunity.
 

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 did not experience discrimination. However, there was evidence of an inequality in the delivery of their care. Although we received no concerns from people regarding fairness or equity in the care and support, they received, care plans did not demonstrate that these areas had been fully explored with people’s involvement.

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.

Care plans did not contain any information to guide staff how to care for people when they were nearing end of life. This meant they may not have information to meet the person’s needs effectively and compassionately. These findings raise concerns about the adequacy and reliability of end-of-life care planning, which is essential to ensure dignity, comfort, and support for people at the final stage of life.