Archived: St. Catherines 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.

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 we reviewed did not always demonstrate how people contributed to the development of their care plans. Some care plans we reviewed did not accurately reflect people’s current care needs. This meant there was a risk that relevant information was not recorded or updated for use by staff to demonstrate appropriate care was being provided and delivered in line with people’s support needs. Feedback from relatives on their involvement in the assessment of people’s needs was mixed, whilst some said they were involved others did not.

Observations at our inspection demonstrated there was the option for people to join social activities being carried out. People were observed interacting and engaging with activities. However the weather was warm, and we found that people were not encouraged or supported to access the service’s garden.

Following our feedback, the provider has agreed to implement audits to help ensure care plans were more robust, accurate and provided guidance for staff to follow consistently. The provider told us additional training on the electronic record keeping system would be undertaken for all staff. We will check on improvements the provider said they are making when we next inspect the service.

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.

People’s care plans in relation to their clinical needs and health conditions were not always clear or detailed, which did not fully support joined-up care. This meant staff did not have the required guidance to provide responsive care and treatment and ensure people’s health needs were known, understood and planned for.

The provider had adopted an electronic care planning system. However, required care tasks, including the support people required with repositioning, were not always visible on the handheld devices staff used and referred to, meaning these may not be consistently completed or correctly logged.

Staff and the management team did not always work effectively with healthcare professionals who routinely visited the service. For example, upon our request, staff could not find records of advice given by the district nurse in relation to a pressure reliving mattress. This meant care was not always joined up to ensure people’s health needs were jointly met.

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

We found people’s individual communication needs had not always been assessed to ensure communication needs were understood and met, in line with the requirements of the Accessible Information Standard (AIS). For example, one person had dementia and experienced some communication difficulties which had not been assessed, recorded and staff provide with clear information and guidance on the approach to meeting these. This meant there was a risk that staff could not effectively support people’s individual communication needs and preferences. However, we saw staff communicate with people in an appropriate way, speaking clearly and allowing people time to respond, where required.

Information people needed was not always tailored to meet people’s individual communication needs. For example, the day’s meal options were written on a white board and did not include any images more fully support people’s ability to choose what they wanted to eat and drink. The provider told us picture menus were being introduced and if information was required in another format this would be provided.

The provider did not always review and use feedback from people, their relatives and staff about the service to make improvements.

The provider had systems and processes that enabled people using the service, relatives and staff to share their experience of the service. For example, the provider invited people and relatives to complete periodic feedback surveys and questionnaires. However, we found no evidence of any analysis of themes, patterns and actions required to make improvements at the service.

The provider also enabled staff to share their experience of working at the service via a satisfaction survey. However, records confirmed that although staff had completed the surveys these had not been analysed by the provider and had not been responded to and acted upon by the management team.

Once we brought the lack of analysis of feedback from staff on the service to the provider’s attention, they did carry out analysis and planned to complete an action plan to address any concerns raised and share these with staff to ensure improvements could be made at the service. This meant the provider did not have an open and transparent approach to listening and involving others to share their experience of the service.

People and their relatives told us they would know how to make a complaint if they needed to. We saw the management team kept a log of all complaints received; however, the log did not include any actions taken to make improvements and prevent a re-occurrence. Following our inspection, the provider told us all future complaints records would include actions taken to address the complaint and prevent reoccurrences.

People and relatives confirmed they received opportunities to share their experience of the service.

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

The provider did not always refer concerns about people’s health promptly to health professionals. We identified concerns regarding the provider’s approach to escalating concerns over people’s fluid intake with professionals. People told us they had access to health professionals. Relatives told us the provider responded well when their family member experienced any accidents, such as falls. One relative said, “When [loved one] had a fall, they called the paramedics right away.”

Staff told us they worked in partnership with other health professionals. However, we found that the provider was slow to act on advice and recommendations community health professionals.
Staff ensured that people were able to continue to receive and attend the regular care appointments they required for their health needs. For example, there was a visiting audiologist on our first day on site, providing a service to people to remove impacted ear wax. This meant health care services continued to be accessible for people, even if their mobility left them unable to leave the service on a regular basis.

Relatives told us they had no concerns in relation to overall access to services or any form of discrimination.

Care records for people contained limited information on their equality and diversity needs. Most people living at the home were elderly, many of whom were living with dementia. However, communication plans and information on how to involve people in expressing their needs and wishes was limited.

Assessments and care planning in relation to people’s interests and preferred activities were not always completed.

The provider’s failure to consistently analyse and act on feedback received from people, their relatives and staff meant they may not be alert to any discrimination or inequality that could disadvantage people using the service.

Staff had undertaken equality and diversity training and were observed communicating with people respecting their own unique backgrounds and experiences.

Processes were in place to seek information from people, relatives and staff about their experiences, but this feedback was not aways used effectively.

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.

As part of the provider’s pre-assessment process, people’s wishes regarding end-of-life care and treatment were discussed and recorded with them. The provider’s electronic care planning system enabled staff to record details of people’s Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) and Advanced Decisions.

Whilst at the time of the inspection no person was on end of life care, the provider had end of life care plan templates available to be completed on the electronic care planning system with the person and their relative to plan their end of life care.