Westroyd 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 service since it was registered under the new provider. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 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.

Family members told us they were kept informed of any changes, not all family members had seen their relatives care plan. A family member said, “They always tell me if they’re unwell, they update me on an ongoing basis, no meetings.” Another family member said, “I’ve always been involved in updating [person’s] care needs, they keep me updated when I visit.” Some relatives were aware of their relative’s care plan. A family member told us, “We had a formal meeting recently and discussed the care plan.”

A family member spoke of how staff had used their knowledge of their relative to engage them in a conversation, which they had enjoyed. The family member said, “Staff laughed and joked with [person] the other day about sailing which they loved. My relative used to play for [rugby team] and they spoke about it, staff seem genuinely fond of [person], which makes me happy.” This is a positive example of how staff providing person centred care, where they have information as to people’s lives prior to moving into residential care.

Improvements were needed to ensure everyone’s care plan was person-centred. People’s care records did not always contain information as to the person’s lives prior to moving into residential care or include information as to their preferences as to how they wished to spend their day, including their social needs. Information about people’s lives, such as their hobbies, interests, family and work life would support staff in providing tailored care. Minutes of a relative meeting had recorded family members had been asked to provide this information.

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’s care and support was documented and shared within the service and with healthcare professionals. Necessary and timely referrals were made to other agencies where required. The registered manager and staff worked in partnership with healthcare professionals. People’s records provided an overview as to external health care professionals involved in their care, which included GP’s, district nurses, speech and language therapists, chiropodists and hospital appointments.

The registered manager told us to support a joined-up approach to people’s care and support; they updated care plans and recorded other services involvement in people’s care. They told us they spoke with people’s family members monthly to ensure they were updated as to their care needs. Family members confirmed they were informed of any key changes in their relatives’ health and wellbeing.

We asked an external health care professional whether staff from their service were invited to be involved in key decisions about people’s care where appropriate. They told us, “Yes. I am involved in key decisions when needed, such as end-of-life and palliative care discussions, and in reviews of residents’ care plans. In some cases where next of kin live abroad, staff have arranged multi-disciplinary meetings that include family members remotely, ensuring good communication and shared decision-making.”

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

People had a communication care plan in place where they had been identified as having communication or cognition difficulties, including sight or hearing. People’s care and support was documented and shared within the service and with healthcare professionals. Necessary and timely referrals were made to other agencies where required. The registered manager and staff worked in partnership with healthcare professionals.

Staff were aware of those people who had communication difficulties and spoke of how they adapted their own approach to support effective communication. This included, ensuring they faced the person when speaking with them and interpreting and responding to people’s body language.

Signage supported people to navigate the service, including bathing and showering facilities. The provider informed us written information was available upon request.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, views and ideas were not consistently acted upon.

Family members we spoke were aware of the resident and relative meetings; however, many said they were unable to attend, and those who did attend said they were not well attended. Family members confirmed they received the minutes of meetings. A family member said, “We’ve been asked to go to meetings, but we haven’t been able to go, they send me the minutes.” A second family member said, “I go to the family meetings they are not well attended, only 2 of us were there, it’s more of an informative meeting.

Some family members said ideas discussed at meetings were not acted upon. A family member said, “My [person] goes to the meetings. We didn’t suggest anything because we had already done so at previous meetings, and nothing happened. A new breakfast bar to encourage resident independence was discussed, but it hasn’t happened.” The registered manager informed us changes had been made to people’s dining experience at breakfast; however, they would review the changes and identify if further changes to improve people’s experience could be made.

The provider had quality assurance procedures which provided opportunities for people’s family members to share their experience of the service by completing feedback surveys. Family members confirmed their views were sought through surveys. A family member told us, “We do a monthly survey. We mentioned the driveway condition, but nothing has happened.” A second family member said, “There is a monthly survey, I’ve said about the drive.” The provider has advised quotes are currently being sourced for the work required.

People and family members told us the registered manager was approachable should they wish to raise a concern, and that they were confident any concerns would be acted upon. However, concerns about the driveway had not been resolved. A person told us, “If I had a complaint I’d see the manager, she’s here 5 days a week, I haven’t so far.” A family member told us, “Any complaints I would go to the manager. Any issues so far have been informal”.

The provider had a complaint policy and procedure. Records showed where concerns had been raised, these had been documented. The 2 concerns received were related to the condition of the driveway.

The registered manager informed meetings with staff had been held following feedback from family members, to address issues raised. These included, staffing paying greater attention to people’s presentation, by ensuring they were dressed in matching outfits. And the introduction of food passports to provide information as to people’s dietary needs.

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

Family members told us their relatives had good access to health care services, and that staff were quick in contacting health care professionals where required. A family member said, “My [person] has been ill a few times, and they got the doctor in quickly. The chiropodist and the hairdresser come, they’ve had a hearing test and new glasses.” People’s care records detailed the involvement of health care professionals in their care. A person told us, “I had one hospital appointment, staff came with me.”

We asked a health care professional if staff considered their organisations views on people’s needs and preferences. They told us, “Yes, very much. Staff consistently consider medical input and seek guidance appropriately. They have a good understanding of their scope of practice and escalate concerns when needed.”

The environment supported accessibility and promoted independence. Signage, handrails and individual equipment such as walking frames enabled people to navigate their way around the service. We saw several people moving around the service, which included using the passenger lift independently without the support of staff.

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.

The provider had systems and processes that monitored people’s care and support needs, including health conditions. Whilst people’s care plans and records confirmed how people’s care and support was provided, we found improvements were needed to improve the quality and consistency of information in some areas.

The registered manager understood people with specific needs, may experience difficulties in being heard and understood when conveying information about their health and wellbeing. To support this, staff and family members supported and advocated for people, when attending health care appointments and visits.

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.

People had their advanced wishes regarding receiving treatment if their health deteriorated recorded, and in some instances, this included information as to people’s funeral arrangements. Family members told us they had been involved in planning for the future, including end of life care. A family member told us they discussed end of life care as part of a recent review of their relative’s needs, they said, “End of life was discussed and do not resuscitate was agreed.” A second family member said, “We have agreed end of life care.”

Staff had received training on palliative and end of life care. Staff told us they made sure people were comfortable and respected their wishes when providing end of life care. Staff told us they involved the person’s family and worked with district nurses who administered end of life medicines, where these had been prescribed.

An external visiting health care professional told us, “Staff communicate with residents’ and families’ concerns clearly and promptly. Senior staff, including the care home manager, are responsive, engaged and compassionate. For example, for residents who are palliative or approaching end of life, the team is proactive in reviewing Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms and supporting sensitive discussions with families.”