Archived: The Chase

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 Requires Improvement. At this assessment the rating has changed to Inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of legal regulation in relation to person centred care.

This service scored 29 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People did not receive care that was personalised to their wishes and preferences. Where people had interests or passions that they were keen to explore, there was no evidence that they were being supported to pursue these. For example 1 person was described as very social and how important it was to offer them a daily choice of activities, however there was no activity at all being record for 2 thirds of days within the last month. Another person cared for in bed was described as having a wide range of interests and would be keen for staff to spend time with them to discuss these, but no 1:1 time beyond routine care had been recorded for the last month.

There were significant shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity.

People were supported by a stable staff team, however they were not always sufficiently knowledgeable about people’s needs or trained to be able to support them safely. This meant we could not be assured that people’s needs could be safely met in a way that was consistent or aligned with best practice. People did not always experience continuity in relation to meeting their needs. The provider's processes to ensure people's ability to be integrated into their local community needed improvement. We received feedback people's activities were not always promptly organised, for example people’s ability to go out was affected by the registered manager telling us they did not have any structured activities planned.

There was a blanket approach to the delivery of care without consideration of people’s diverse needs including those living with dementia or a mental health diagnosis.

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

Improvements were needed for providing information in a way that was dementia friendly, for example people did not have access to a pictorial menu to assist people in making choices. A number of doors to people’s bedrooms had no identifying features such as a picture which increased the risk of people becoming disorientated. However, staff had information on how to communicate with people who may struggle to do so verbally, such as reading body language or visual cues. Whilst staff were generally able to articulate this information and demonstrate this in practice, we saw examples of staff being in people’s room without attempting to engage with them which was not respectful or dignified.

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

There were systems for people to share feedback, including a monthly service user meeting and feedback surveys for relatives and people. However where people had described the things that were important to them such as their faith and activities and interests that were meaningful to them, the provider had not acted on this to ensure they were supported in line with their wishes. For example a number of people had expressed they enjoyed gardening, yet the rear garden was overgrown and continued to be unable to be used despite this being identified at the last inspection. There was mixed feedback about how well people felt involved in their care or that of their loved ones. One person told us “If I had a problem I would always talk to the staff, if anything needs doing they will do it straight away”. However, a relative told us “I don’t get regular feedback. I don’t know whether I should have been more demanding, or what you should expect”.

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

People could not consistently access the support they needed, when they needed. This included routine offering of nutrition and hydration, access to support for people who were cared for in bed, and access for rescues medications. This meant people with more complex health needs or who may be unable to communicate as easily faced greater barriers in accessing the care they needed to meet their needs.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

People were not consistently treated with equality, or to have access to the things people in wider society may take for granted. Where people were cared for in bed we saw people received minimal non-task based engagement, which significantly increased their risk of social isolation. People who had a faith were not empowered to have access to meaningful religious engagement that was personalised to them. People did not live in an environment that was dementia friendly, and had no access to green space as the rear garden was overgrown and inaccessible. This was despite the importance of green space to supporting wellbeing, reducing anxiety and provide sensory engagement for people with dementia.

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.

Staff supported people to plan for significant life events, such as discuss what their wishes were should their health deteriorate. However, where these plans were in place they were not always followed, for example one person was described to inspector as being at end of life but was still being awoken for personal care and not having their mouth moistened to support their dignity and comfort.