The Garth Care Home with Nursing

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 as good. At this assessment the rating has changed to inadequate.  This meant services were not planned or delivered in a way that met people’s needs.

We found the provider in breach of 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 failed to ensure people were at the centre of their care and treatment choices and did not work in partnership with people to decide how to respond to any relevant changes in people’s needs.

People’s care and support did not reflect people’s choices and preferences. People were not routinely included in the planning or reviewing of their care. Care was task driven and we did not always find staff responding in a person-centred way.

The provider failed to have a comprehensive view of risks to people, this did not enable active exploration between the registered manager and individuals on how to reduce further risks.

Key information about the needs of people were missing from care records and staff were directed to external sites including Wikipedia with the intention of informing staff of key aspects of managing risks around a person’s communication. This demonstrated a lack of person-centred information and sources of information which were lacking in evidence based, reliable data.

People’s health conditions which required monitoring, detail and assessment did not receive this. Staff were making decisions to treat a person’s seizures without the details to demonstrate treatment was provided in line with the persons individual needs.

People told us they did not feel care was provided in a way that was personal to them. A person who had a past of working outdoors did not have adequate opportunity to go outdoors and there was no recognition from staff or the provider over the importance of these skills to the person or of the potential detrimental impact on the person’s health due to the lack of engagement and opportunity.

The provider and registered manager did not have the necessary understanding of the diverse health and care needs of people in the service meaning care was not always effective or promoted continuity.

People experiences did not reflect consistent or positive care. Whilst some people were able to advocate for themselves, others were not and we were not assured of how people’s care was provided.

We observed mixed interactions from staff towards people living at the home. Some staff were positive and engaged with the people they were supporting, while other staff did not always engage with people outside of personal care tasks.

Staff lacked the skills and direction from the provider and registered manager to provide safe and effective care, with the provider having poor management of people’s risks and needs. This did not promote or support a good standard of care for people. People were not engaged in meaningful activities and there were limited opportunities for people to actively engage with their care and with their peers.

There was an increased risk of isolation and people were not provided with adequate opportunities for integration into the wider service.

People we spoke with were not always aware of their care plans or risk assessments and there was no evidence of consideration to communicate information about individual needs to people in the service. While some information was provided in a pictorial format, for example menus at mealtimes, staff did not always provide the time and encouragement to people to ensure they understood the choices available to them. Reviews and details in peoples care records did not demonstrate how information was provided or shared with the person receiving the care. This meant we were not assured people always had accessible information available to them to be involved in their care, or to make informed decisions and choices over their daily lives.

The provider did not ensure people could share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care. People were not always asked to contribute to care plans and risk assessments. The registered manager was unable to demonstrate how people’s views were gathered.

People we spoke with did not feel listened to or that their feelings about the care they received were heard or acted upon.

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

The provider and registered manager did not have effective oversight in the management of risks with gaps and inconsistencies in documentation available to staff. This meant the provider had not ensured an accurate and complete record of people’s care was available.

People were not always provided with opportunity to access and engage in activities and stimulation in the home, as well as access to the community outside of the home. There was limited evidence of how people were actively supported to reduce the risk of social isolation.

The provider and registered manager did not demonstrate an approach that considered people’s experiences. There were no systems or approaches in place to engage with people about their experiences of care or to review and improve the outcomes for people who were further disadvantaged due to the complexity of their care needs.

This meant opportunities to improve people’s experiences and outcomes were missed. This had not been highlighted by the registered manager or provider as a concern until identified during the inspection.

Whilst the provider had policies and procedures relating to end of life care, paperwork was not always clear in how people were involved in planning for their future.

People did not have wishes or aspirations recorded and there was no demonstration of an approach to care which promoted future goals and objectives for people.