St Nectans 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.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.People were treated as individuals and staff knew a lot about the people they support. However, there was a lack of activities to promote their well-being and to ensure their social needs were met. Staff knew how they liked their hair and clothes, and what they preferred to do and to eat and drink. People and relatives were encouraged to share their views and relatives felt well informed by the staff and management team, particularly when there were issues or concerns.

This service scored 71 (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 support choices on a daily basis.

People told us, “I have settled in well, I do like it here” and “I was living in Bexhill before, so I am glad to find this place.” A relative said, “Very happy, care good and always consult me, but I am not sure there is a lot of activities, so that could be better I think.” Another relative said, “Yes they took time to get to know my mum and her needs and preferences and listened to me and my information on my Mum also.” Staff told us, “We try to ensure we get it right; we don’t have time really to do activities, we do try though.”

There was an activity plan displayed but as there was no dedicated activity person, and activities were not always provided, staff said they did what they could, but recognised it was not ideal. This was discussed with the provider, who was actively recruiting to the post. In the meantime, an extra staff member will be deployed to provide activities.

People's care plans and risk assessments were personalised for each person; however, information was not all kept up to date. For example, one person had been very unwell and whilst staff had contacted the GP and received medication for a chest infection, this was not reflected in the persons’ care plan. We were told that they would update the care documentation at the end of the month when it was reviewed. However, this meant that essential information was not available to staff or to external health professionals if required. This was immediately rectified.

Daily records reflected peoples’ personal care but lacked any mention of peoples’ mental health or emotions.

Care documentation enabled visitors to engage with people as they reflected people’s individual interests and preferences for communication support. People’s personal care was person specific and supported by information about how they wanted their personal care provided. Staff were considerate and respectful of people’s individual needs when they supported them. For example, people in their rooms were comfortable and staff ensured that they had their favourite music on, or television show and staff interacted with them positively, addressing them by their preferred name. During mealtimes, staff assisted people if they required it, by prompting or by assisting them to eat. There was a relaxed atmosphere and people enjoyed their meals.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People told us, “The staff arrange my Doctors appointments, they come here to see me, and they let me know if I need to go to hospital” and “I have been taken to a dentist when I needed to go.” Relatives told us they felt well informed and assured that if needed, specialist advice would be sought straight away. One relative said, “They contact me immediately, so I can go with my relative to appointments.”
Staff told us that they worked alongside families and always inform families of any appointments and keep a record of the appointment and advice given.
A health professional told us, “Staff are always professional and polite. They know residents well and contact us when needed.” We were also told, “No complaints.”
Care plans were reviewed and contained information about people's care needs, including any health and medical needs. They also included evidence of regular partnership working with health professionals such as specialist nurses, and therapy teams. These records were well documented and showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality, or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Relatives told us that they were provided with information in a timely way. One said, “They ring me in good time, let us know when things happen.”

Some staff told us that they thought people would benefit from some dementia friendly aids that would help them to understand information, for example in finding their way around, or to choose their meals or activities.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment, or sensory loss and in some circumstances to their carers. Staff responded to people’s communication needs. These were assessed and recorded within individual communication care plans. These included specific information on how people’s communication needs could be met and what aided their communication. For example, those who needed spectacles or hearing aids had specific care plans. Systems to support people to communicate with staff, relatives and friends had been assessed and promoted. For example, video calls were set up and staff supported people to phone their loved ones, as necessary. There was a lack of portable communication aids used - such as pictorial aids-for those who struggle to understand words. There was signage on toilet doors and bathroom doors and on some people’s doors, however this was not consistent throughout the home.

All care plans were on a computer and going forward will be printed off for family, hospital appointments and transfers. They could also be enlarged for those that have sight impairment.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result.
People told us they were asked for their views and felt listened to. Comments included, “Always talk to me about things, doctors’ appointments and such,” and “I feel very involved in my care.” Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions proposed and taken were then discussed at the next meeting.
There was a complaints policy and procedure, we saw that concerns raised had been responded to promptly and thoroughly. The management team kept a log that ensured the manager had an overview. They told us they had an open-door policy, and we saw people and relatives popping in to speak to the manager to share information and ask questions. Relatives told us, “If I had a concern or worry, I go to the person in charge, never felt there was a problem."

The provider made sure that people could access the care, support, and treatment they needed when they needed it.

People and families said there were no barriers to access care and treatment, and they felt it was done in a timely way. One person said, “I see a doctor when I need to.” Relatives confirmed that their loved ones attended appointments in the community and hospitals when required. One relative said, “Yes, she has everything she needs and is very well looked after, she has improved a lot since moving to St. Nectans, it’s lovely to see.”

Staff confirmed that people were able to access care, treatment, and support when they needed to. Staff said, “We ring the surgery for advice if we are worried, someone from the surgery visits weekly.” One staff member said about the environment, “There is pretty level access everywhere, we have ramps between the houses and lifts so everyone can go where they want to. The gardens are not really easily accessible for everyone at the moment, but the provider is working on that and the front garden as well.”

One health professional told us, “Always polite, genuinely seem to care about their residents.” Another health professional said, “They know their residents well.”

Families and staff confirmed people were able to access care, treatment, and support when they needed to. There was evidence within peoples care records that when staff identified a health issue, they acted immediately, and people received treatment and care promptly. Records showed staff had received training in Equality Diversity and they explained how they treated people equally, without discrimination and respected their individual needs, including any religious or cultural needs. People’s care plans contained information about their wishes in relation to how their social, cultural, and spiritual needs needed to be met. This included care plans around sexuality, emotional support, and daily lifestyle.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support, and treatment in response to this.

Relatives told us that their loved ones were included and involved in the running of the home and that they, as visitors, felt welcomed and listened to. One relative said, “We are always welcomed – we can visit at any time.” Another said about visiting, “I visit once a week, no appointment is needed.”

Staff told us, “People are always treated with respect, no-one is discriminated about we do have situations sometimes with behaviours that may distress but they are not treated any differently, we care for all people, with many various differences.”

There was evidence of regular review and support from supporting health professionals within peoples' care plans. Staff ensured families were involved in all decisions. There were no restrictions to visiting, families were welcome at any time. There were organisational polices that ensured the provider complied with legal equality and human rights requirements.

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.

Staff worked closely with people and their loved ones to make plans about their future care. For example, people and their families were involved in planning how they would like to be cared for at the end of their lives. It was acknowledged that some people found these discussions difficult and so staff gathered information slowly and added key details after hospital admissions. Care plans identified people's preferences at the end of their life and the service co-ordinated palliative care in the care home where this was the person's wish. Care plans contained information and guidance in respect of peoples' religious and resuscitation wishes. People had ReSPECT forms. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment and ensures their personal wishes are followed. People also had a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decision, also known as a DNR (Do Not Resuscitate) order,which were accessible to all staff and health professionals should a situation arise.

DNACPR and ReSpect forms were discussed with people and families, staff made sure people understood their options and what it meant to request withdrawing care, or not receiving care, to allow them a dignified death.