The Rookery 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. 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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff knew people well and communicated changes to people’s needs during team meetings and handovers. We observed care and support was person centred. For example, we observed good interactions at lunchtime between staff and people and people appeared to enjoy the food they were being given.

Staff supported people effectively to make informed choices about what they wanted to eat and drink. People were offered a balanced diet, and kitchen staff were aware of any special dietary requirements, including diabetic diets. People and relatives told us they were happy with the quality and variety of food. A relative said, “The food is very good. They geta big variety of food choices to eat. Lots to drink, including the visitors. That’s very nice.”

Staff spoke well of the people they cared for and showed passion for the work they did. One staff member said, “I like working with the residents. You hear different stories every day. You are part of their world when you interact with them.” Another staff member said, “You walk in and there could be a particular resident who can be unhappy sat at the door and just by you smiling at them or saying hello and it makes them happy.”

This meant people received care that reflected their individual needs, preferences, and what mattered most to them.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities. However, we found care was joined‑up, flexible, and supportive of choice and continuity.

Staff had a good understanding of most people’s health care needs and were aware of which professionals were involved in people’s care. There was a core team of staff who knew people well. Agency staff were not used, instead existing staff would cover shifts when there were shortfalls. However, there were gaps in knowledge in specific areas. For example, some staff had limited understanding of how to support a person with a diagnosis of epilepsy in the event of a seizure. The registered manager advised us it was unlikely any people would experience a seizure. However, we found if this were to occur, staff may have taken incorrect action, which could place a person at risk of harm. This highlighted systems to ensure staff had the necessary information and competence to respond to all potential health needs were not fully effective.

Staff worked with other stakeholders such as local authority and health professionals for joined up working. We observed staff working cooperatively with district nurses during the day of assessment as well as responding to people’s requests for GP appointments.

This meant although there were clear examples of effective collaborative practice, gaps in staff knowledge, documentation and overall care coordination meant people did not always experience care that was fully integrated or consistently aligned with their ongoing needs.

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

Signage throughout the home did not include clear visual symbols, appropriate contrast, or accessible language. This meant people living with dementia were at increased risk of confusion, disorientation, and distress. For example, key areas such as toilets, dining rooms, and bedrooms were not clearly marked in a way which would support people’s independence or reduce reliance on staff.

This did not reflect best practice in dementia care, where accessible and tailored information is vital to promote autonomy, dignity, and safety. The absence of dementia-friendly tools may also limit people’s ability to make informed choices and participate meaningfully in daily life.

Staff did not demonstrate an awareness of the importance of accessible information for people with cognitive impairments. There was no evidence the service had assessed or reviewed people’s individual communication needs in line with the Accessible Information Standard.

This meant people may struggle navigate the building, feel disorientated and unsafe, and could lead to reduced independence and increased risk of harm.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. The management team did this by ensuring staff and managers were approachable and acted proactively when concerns were raised. However, staff had not always followed the provider’s policy for reporting complaints to the management team when they had received informal complaints verbally and resolved them directly with the person. This meant not all concerns were formally recorded or reviewed, which limited opportunities to identify learning or themes.

People and their relatives felt involved with creating and updating care plans. However, there were not regular resident or relative meetings or surveys to collect feedback. This meant the service did not have systematic ways of gathering the views of all people and their families, including those who may be less confident in raising issues directly with staff.

This meant there could be missed opportunities to learn from complaints and to gather valuable feedback from all people and relatives about where improvements could be made, rather than relying solely on those who had spoken directly to staff or managers.

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 ensure people had equitable access to the care, support, and opportunities available within the service. While staff were committed to supporting people well, the systems in place did not consistently identify or respond to barriers which could prevent individuals from accessing activities, health services, or information in a fair and inclusive way.

Many people using the service were living with dementia, yet the environment was not dementia friendly. The lack of clear signage, visual cues or orientation aids meant people living with dementia faced greater challenges in navigating the building and locating communal areas or resources. This resulted in avoidable barriers which limited their ability to independently access activities, information, or areas of the home, reducing their opportunities compared to those without cognitive impairment. As a result, people living with dementia may not have always experienced the same level of autonomy or ability to make informed choices about how they spent their time as environmental barriers may have reduced their ability to communicate needs or navigate the service independently.

There was a lift to reach the upper floor, and people who used walkers, wheelchairs or adapted chairs were able to move around the service. These adjustments supported physical mobility. Most people had access to personal care and medical support. People described staff as helpful in arranging GP appointments and responding today-to-day health needs. One relative said, “They phoned the doctor who comes to the home once a week. The nurse comes every day. They have been to the opticians.” However, some people and their relatives told us access to dental care was limited.

This meant the provider could not be assured everyone received fair and equal access to support, information, and opportunities. Despite examples of good practice, inconsistent systems, limited accessible information and an environment which did not support people living with dementia meant not everyone experienced the same level of inclusion or access to the full range of care and support available.

Staff and leaders did not always 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 did not proactively seek or act on information about groups at higher risk of inequality. Shortfalls identified meant the service did not consistently gather or respond to feedback which would highlight early signs of unequal experiences. Informal concerns were not always recorded, and limited opportunities for structured feedback reduced the provider’s understanding of where inequalities might exist.

Many people were living with dementia, and some with a learning disability, although this was not their primary care need. These groups may face additional barriers in expressing preferences or understanding information. However, there was limited evidence staff were supported to recognise or respond to these specific inequalities. Many staff had limited knowledge about dementia friendly practice and were not aware of what adaptations might be needed for people living with dementia.

This meant the provider could not be assured people received equitable experiences or outcomes. Although there were examples of caring practice, the lack of dementia friendly awareness, limited understanding of learning disability needs and inconsistent feedback processes meant care was not always adapted to reduce inequalities or meet people’s diverse needs in a person-centred way.

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. At the time of the assessment no one was in receipt of end-of-life care, however care plans contained clear details of what people wanted to happen in the event of an emergency.

Staff knew what to do when someone was receiving end of life care including contacting necessary professionals and knowing what things to do to make the person feel comfortable including checking their wishes in their care plan. One staff member said, “Just sitting there holding their hand so they know they aren't on their own. We have sensory lights and calming music too, so it is peaceful for them.”

The registered manager told us what actions the home takes in planning for the future, including when people don’t feel comfortable discussing certain matters including death. They said, “First and foremost we have the conversation with the family, and we have a questionnaire that we ask the family to fill out for us. As and when they feel the time is right. It is getting to know their preferences. It is personalising it for what they want for a good death.”

We found an example where an end-of-life care plan needed extra detail adding to it as it did not contain person centred information such as the individuals wishes. We fed this back and the management team told us they would review this.

This meant people were supported to think ahead and make informed choices about their future care, helping to ensure their wishes were understood and respected as their needs changed.