Catchpole Court

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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 requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to consent to care and treatment.
 

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found some records were not completed accurately or there were discrepancies with the information provided as referred to in other areas of this assessment report.
We found daily records of care and support provided were task focused and contained limited information about people’s well-being.
Further work was needed to ensure people living with dementia with limited communication skills had pain management plans to provide staff with guidance as to how people expressed pain and what to do in response.

Where care plans described people as ‘gets anxious and aggressive’ there was for some people little or no guidance for staff in how to recognise triggers and what their response should be to de-escalate situations and support people’s wellbeing.

Feedback from relatives and people who used the service showed that people did not always have access to regular baths and showers as they wished in accordance with their plan of care. This was further evidenced from a review of daily records maintained by staff.
People who had been admitted to the service for periods of respite care did not always have a care plan in place which would guide staff as to their needs including people with complex health conditions. For example, we found one person at high risk of falls and with a number of complex health needs without care plan guidance for staff in meeting this person’s needs despite them having been admitted to the service 10 days prior to our visit.
Improvements were needed to ensure care plans provided evidence that people's cultural and religious needs had been fully considered and assessed.
People were supported by external professionals and referrals were made to external professionals where required. For example, people were referred for a Speech and Language Therapy (SALT) assessment following a swallowing concern, and when concerns regarding weight loss identified.
 

Relatives gave positive feedback in relation to how the service worked in partnership with other agencies. This included the support received from joint working with healthcare professionals.
Staff understood their responsibilities in making sure people could access healthcare advice and treatment.
We received feedback from partner agencies of positive working relationships in response to safeguarding investigations.
Health care professionals were involved in supporting and advising on the care people received. There were regular GP visits and if emergency appointments were required, these were facilitated. Advice given from healthcare professionals was recorded and shared with other staff and relatives appropriately.
 

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
Signage around the service was not always evident to guide people including those living with dementia to orientate around the building.
The Accessible Information Standard [AIS] was not fully implemented within the service. We found some information on display would not always be accessible for people. For example, the complaints procedure was displayed but the print was small and could be difficult to read for some people living at the service.
Information was not routinely provided in formats such as easy read, pictorial or suitable for people with sight impairment. Notices were also located up high and not easily accessible to people in wheelchairs. The registered manager told us, “If people need information in different formats, we can provide it if they ask.”

The provider’s complaints policy did not contain contact information to signpost people who may wish to contact CQC.
 

People were given opportunities to provide feedback about the service and raise complaints about their care, treatment and support.
The provider had a complaints policy which detailed how people could raise concerns if they were dissatisfied with the service they received and the process for dealing with their concerns.
We observed formal complaints received were not always logged within the providers system with records maintained describing any actions taken to improve the service with outcomes. This meant the provider did not comply with their own policy on the handling of complaints.
Relatives told us whilst they felt able to speak openly with staff they were not always provided with feedback as to their concerns and complaints raised. One relative told us, “I have complained to staff about the lack of access to a shower for [person’s relative] but did not receive any feedback or reassurances from the management as to what if anything they did about it.”
 

There were systems in place to regularly seek feedback from people and relatives as to the quality of care received. We did not identify any concerns in relation to people being able to access external services.
People and their relatives were invited to attend and had access to surveys where they could express their views about the service provided.
Relatives told us that specialists and health professionals were consulted for advice and guidance when needed. Examples were shared with us of contact being made to source support from GP’s, falls prevention teams, speech and language specialists for advice and support. Staff told us they had systems in place to look at people’s likes and dislikes and how this included planning to ensure foods that people liked were included on the menu.
 

There were systems in place to regularly seek feedback from people and relatives as to the quality of care received. We did not identify any concerns in relation to people being able to access external services.
People and their relatives were invited to attend and had access to surveys where they could express their views about the service provided.
Relatives told us that specialists and health professionals were consulted for advice and guidance when needed. Examples were shared with us of contact being made to source support from GP’s, falls prevention teams, speech and language specialists for advice and support. Staff told us they had systems in place to look at people’s likes and dislikes and how this included planning to ensure foods that people liked were included on the menu.
 

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.
Whilst staff knew people’s immediate needs well, those we spoke with were not able to describe the longer-term plans for people and said this information was not always available to them in care plans.
We were not assured people had been provided with the opportunities to express their needs and wishes in planning for the end of life and in the event of death. Some people had DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) forms in place to guide staff of their wishes, however, people’s care plans did not all contain information about their wishes for the future.
There was a lack of end-of-life care plans in place. Where these were in place plans were brief in detail containing little information and did not express the voice of the person as to their needs and wishes. Examples of staff recording in end-of-life care plans; ‘[Person using the service] is not at the end of their life yet, and therefore doesn't have a need identified', ‘n/a’ and ‘no need’.
People’s relatives told us they had not been included in any discussions around end-of-life care. One person’s relative said, “We have not been asked for any information or had any discussions on end of life by any of the staff or the manager.”
End of Life care plans that were in place were not updated where people had been prescribed anticipatory medicines (medicines that are administered to alleviate symptoms at the end of life if necessary).