Drumconner Lancing

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 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 and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Care records were not person-centred and did not contain details of what was important to people.

Care and support were not planned based upon people’s individuality and preferences, for example, moving and positioning care plans guided staff to refer to their moving and positioning training rather than contain person-centred information about people. Some people displayed distress and anxiety when being supported indicating their support was not being delivered in a person-centred way. One relative told us they were not always involved in decisions about their loved one’s care. “There has been an incident lately where we found [loved one] eating pureed food which they don’t usually, I questioned it and was told that the SALT team had been in and said this was what they needed. I looked at the care plan which doesn’t say this, so I questioned again and was told that the care plan needs updating.”

We observed people received care that was not always person-centred, staff were seen to communicate with relatives about a person’s choice of drink rather than speaking with the person directly. Staff were able to accurately describe what and who was important to people and how they liked to be supported. Although most staff knew people well, care records did not include person-centred details to ensure all staff were aware of people’s wishes and needs.

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. A healthcare professional provided positive feedback, “I do feel the staff have the appropriate knowledge and skills to support their clients safely. Drumconner management, in my experience accept new residents from a variety of settings, they complete a full assessment prior to them moving in and would only accept residents they feel they are properly able to support.” Whilst professionals spoke positively about the knowledge of the team our assessment identified some shortfalls in the services knowledge about supporting people who lived with dementia. Staff did not always receive training to help them understand the challenges the people they supported may face. Additional support was not always sought from mental health professionals and professionals who specialised in supporting people living with dementia. This meant people did not always receive consistent support which promoted their choices.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Care plans did not provide personalised details to guide staff with people’s communication needs. For example, a person had very limited communication due to their dementia. Their care plan identified they could understand and answer short questions, but no other tools had been considered to aid communication such as the use of pictures, symbols or objects of reference.

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. One person told us they had not received feedback following on from their complaint, “Once I was woken up by an agency staff to move, they [spoke to me abruptly]. I told the nurse in charge, and they didn't come back to me.” This meant the person could not be assured their voice had been heard.

Relatives gave mixed feedback on the complaints processes their comments included, “We have made complaints and things improve for a while and then slip back.” “I know how to complain but mostly problems are due to too few staff.” And another relative said “I would just tell them although I haven’t needed to.” The registered manager told us they had a complaints process in place and people were supported to share feedback through regular resident meetings.

Staff told us they would report any concerns to the registered person.

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

The provider had an ongoing programme of improvements to the home and had recently completed the addition of a further 6 rooms to the service. Consideration had not always been given to the décor to ensure it met the needs of people living with dementia. There was no dementia friendly signage around the service to help people identify communal spaces and bathrooms. A garden area was available which we saw people freely use.

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 at risk of inequalities did not always experience positive outcomes. There were examples of missed opportunities of people receiving professional input, for example, specialist advice for people living with dementia andguidance for staff to support people when they experienced distress.

Although we identified some missed opportunities, health and social care visits were arranged in the service when people were unable to attend outpatient appointments, for example,the GP visited regularly and along with other health professionals ensuredpeopleshealth needs were reviewed regularlyA healthcare professional told us, “We work closely withsenior staff, not only on the weekly ward round but throughout the week via email etc.. The communication betweenDrumconnerNursing Home andthe surgeryis excellent. From registering a new patient with the surgery to organising new medication or changes made to medication.”

People were generally 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. The service was supporting people at the end of their lives at the time of our assessment. People’s end of life wishes were not always documented in their care records. Decisions such as Do Not Attempt Cardiopulmonary Resuscitation and other formal documents were in place and care plans contained practical and clinical arrangements. However, person-centred details and wishes were not included to inform staff details of how a person wished to be supported holistically. Whilst there were shortfalls in the level of information recorded, health professionals spoke positively about how Drumconner Lancing supported a person and their loved one at the end of their life, “They have supported many residents at the end of their lives and I have always found this care to be of a very high standard, not just for the resident but the relatives are considered too. An example of this is, a resident came for palliative and end of life care and their loved one visited daily from early to late, they were treated with compassion, fed and cared for too.”