Houndswood House 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 inspection when the service was run by the previous provider, we rated this key question good. At this first assessment under the new provider the rating has changed to inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of legal breaches of regulation in relation to person centred care and care at the end of people’s lives.

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 work in partnership with them, to decide how to respond to any relevant changes in their needs. Though work was ongoing to make improvements to care plans some of those we reviewed still required work to ensure they were personalised to people’s individual needs. There was limited evidence of people’s and/or their relative’s involvement in this process. The culture in the service was not person centred. Staff engagement was poor and focused on tasks rather than people as individuals. We carried out observations in a communal area and found staff were either not present or walked through without engaging with people. People did not have enough to do, and people were at risk of feeling isolated, particularly those cared for in bed. Although the activities coordinator scheduled one to one visits with them, these were often cancelled and people told us they missed these.

Staff appeared to know people’s basic needs well but were slow to respond to people’s immediate needs. We observed that domestic staff engaged well with people.

The provider did not understand the diverse health and care needs of people, so care was not joined-up, flexible or supportive of choice and continuity. People’s health conditions were noted within their care plans, however, information to guide staff on how to manage these health conditions was not always available. Where there were changes in people’s needs or advice from professionals this information was not always recorded in the person’s care records, so information could easily be missed. Therefore, we could not be assured the service ensured continuity of care regarding people's health care needs.

The provider did not supply information in formats tailored to individual needs. Information on the noticeboard was not presented in accessible formats. This meant not all people had access to information about meetings and events. People’s records did not contain guidance for staff to use communication aids.

Throughout our 3 site visits we did not see any information in accessible formats or communication aids being used by staff. However, some people’s records identified where people did not communicate verbally and provided some guidance to staff about how to communicate effectively, such as facing the person and speaking in simple language.

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 involve people in decisions about their care or tell them what had changed as a result.

People felt residents’ meetings were not effective. A person told us they were not followed up and minutes or outcomes were not shared. They said, “Yes there was one last week – no minutes ever”. Another person told us they found it difficult to speak in residents’ meetings. We requested meeting minutes and survey results from the provider; these were not shared.

The provider’s complaints procedure was not effective. We saw 3 complaints recorded, 2 of which had no action recorded, so it was not clear whether these had been fully resolved. The electronic care documentation system had the capability to log complaints but was empty.

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

Due to inaccurate record keeping we could not be assured timely referrals to health professionals were made where required. However, we saw some referrals were made and people did have access to the GP.

People had call bells in their rooms to alert staff if they needed help and where they were unable to use call bells, there were regular checks by staff. However, people said they sometimes had to wait a long time and 1 person told us their call bell had been left out of reach.

The premises were fully accessible and there was lift access to all floors.

We saw the diverse service user group living at the home reflected the local community.

Staff and leaders did not listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. People were not always supported to engage in meaningful activities which met their individual needs and preferences. People cared for in bed were at risk of social isolation and told us they were bored and lonely.

The provider had not always ensured they found out the views of people less able to speak about their needs and preferences. Engagement was generally minimal and there was little evidence people’s communication needs had been thoroughly explored and addressed.

People’s end of life care was not managed well. A recent incident had occurred where staff were not confident to recognise the signs of deterioration indicating a person was reaching the end of their life. This meant we were not assured people could expect a dignified pain free death at this service. There were recent concerns identified in relation to the management of medicines including anticipatory medicines prescribed to reduce discomfort and pain at the end of life. Where these medicines were prescribed for a person, they had not been logged on their records, so if they had needed them staff may not have known they had been prescribed. The acting manager had arranged training for staff to develop their skills in recognising deterioration. However, not all staff expected to attend did so and further training was to be rearranged.

As care plans were being updated, increased detail was being recorded about people’s end of life wishes and their cultural and religious needs in relation to death and dying.