Restgarth Care Home

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• 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 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 safe care and treatment and dignity and respect.

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 always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s care plans were inaccurate and had not been regularly reviewed and updated. People and relatives were not all aware of care plans. There was some information about people’s backgrounds and what mattered to them, but this was limited. Care plans had not been updated to ensure they reflected people’s needs accurately.

However, relatives told us staff knew people well. Comments included; “[Member of staff] also talked to us about what [relative] most liked to eat, which is eggs. Sometimes [member of staff] would have some eggs cooked especially” and “We have talked to the staff about mum’s life and interests, it’s important that they know about the people they look after.”

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.

Staff told us people were not being supported to access the community as often as they had been in the past. Relatives also commented on this change.

Healthcare professionals visited the service to provide care and guidance. This included GP’s, district nurses and dentists. Feedback from professionals was varied, comments included; “There appears little leadership when I visit. Senior carers appear to have variable knowledge. A couple of times when I visited I asked carers to stay but they kept wandering off; I had to be quite blunt to request them to stay” and “I’ve made suggestions ……..with a senior manager or deputy if needed when they are away to maintain consistency and have someone who knows what’s going on with people but this has been ignored.” This reflected the lack of oversight in the service.

However, other professionals commented; “Management are approachable and receptive to feedback, responding promptly to queries or concerns” and “Residents seem happy and relaxed, and the staff are knowledgeable about their needs.”

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

Some people had care plans relating to their communication needs. For example, whether they used hearing aids or needed glasses for reading. However, the information was not always accurate. One person’s care plan stated they were able to communicate verbally. A senior manager and a relative told us the person’s communication was poor.

The menu was written on a blackboard mounted on the wall. This was not accessible to everyone living at Restgarth. There were no alternative formats available. Staff had not completed training for the Accessible Information Standard and not all staff had up to date training in communication skills.

The provider did not 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.

People and their relatives were not routinely asked to feedback about their experiences. Resident and relative meetings had not been arranged.

Relatives told us they knew how to complain. Feedback about how the service responded to complaints was varied. One relative told us managers had listened to their concerns and responded openly, taking action to address the concerns. However, we found the actions taken had not been effective. Another relative told us of an occasion when they wanted to raise an issue but said, “There are no managers about to raise it with.” When they had made a complaint, they told us nothing had been done to prevent the problem recurring.

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

Some people were cared for in bed and were particularly reliant on staff to meet their needs at all times. Call bell logs showed staff did not always respond to requests for support in a timely manner.

People had access to other health professionals such as district nurses, chiropodists and dieticians. There was a GP linked to the service who carried out weekly consultations. However, we found one person had been identified as needing a Speech and Language Therapy (SALT) referral in May 2025. This had not been completed.

Staff and leaders did not 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.

The provider failed to recognise the inequalities people may face. These inequalities and people’s needs were not always considered. People were not supported to access their community. Reasonable adjustments had not been made to the environment to enhance the independence of people living with dementia. The activities provided were limited and not designed for people living with dementia or for people who were cared for in bed. This meant action had not been taken or considered to address and remove barriers ensuring people had equal opportunities to live a full and varied life.

People were not 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.

People did not have end of life care plans. Any information about people’s wishes at this time of their lives was limited to their wishes to not be resuscitated or treated in hospital.