Chapter House 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 Requires Improvement. This meant people’s needs were not always met.

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.

People did not always receive person centred care.

Some people using the service felt they did not receive the level of care they expected. Personal preferences were not always taken into account and recent changes to how staff were deployed had affected this.

Staff were committed to their roles and enjoyed their work but said the recent transition had been challenging. They reported that managing staffing across three floors was quite difficult, and although they tried their best with what they had, the provider’s staffing approach did not always enable consistent, person-centred care.

The provider ensured that people and their relatives were actively involved in planning their care. When a person’s needs changed, staff reviewed the relevant information, discussed available options with them, and made care decisions that respected each their wishes.

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.

People and relatives told us that frequent changes to staff allocation were disrupting continuity of care and causing distress. One person explained, “The biggest bug bear at the moment is that staff are changing, management are moving staff around a lot and the people are getting confused.” Another person told us they had previously benefited from a stable staff team, but this was no longer the case: “There was a nice set of staff on this floor, now some of them are not used to people’s needs on this floor. I know they need to know the needs of everyone here, but it is unsettling a lot of people, especially those with a dementia.”

People reported that these issues had developed over the previous four weeks, with staff being moved between floors and new staff unfamiliar with people’s individual needs, preferences and routines. One person said, “You just get used to people working with you and knowing all your needs, likes and preferences and then it’s all changed and they don’t know you.

The manager told us they had recently begun moving staff between floors to improve teamwork across the service. While this change aimed to strengthen the staff culture, it had resulted in some staff being less familiar with people’s established needs.

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

People had communication care plans in place which ensured the staff were aware of their preferred methods of communication. The provider ensured information was available in formats that were tailored to persons needs and in line with The Accessible Information Standard (AIS). The AIS sets out how organisations should ensure people who have a disability, impairment or sensory loss get information they can access and understand and any communication support they need from health and care services.

The provider had systems in place for people to share feedback and raise complaints; however, these were not always effective, as responses were not consistently provided in a timely manner.

Complaints were appropriately recorded in the complaints log, fully investigated, and outcome letters were issued to complainants once investigations were concluded. Although systems were in place to enable feedback and complaints to be raised and managed, they were not always consistently followed and feedback was not always effectively, explored, or used to ensure concerns were properly addressed and acted upon.

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.

People were treated fairly and without discrimination. However, people living with dementia did not always have the same opportunities to take part in meaningful activities as those who were more independent. Although a range of activities was available, these were not always fully tailored to meet people's individual needs, abilities, or preferred ways of engaging for people with cognitive impairments.

Care records showed people could access a range of health and social care services suited to their needs. Records also indicated that people were given choices, and they confirmed that staff consistently respected those choices.

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.

Staff had completed training in equality and diversity and demonstrated a clear awareness of discriminatory practices. Staff understood the importance of involving people in decisions, ensuring their voices were heard, and taking account of any inequalities or barriers, they might experience.

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 end ‑of ‑life care plans in place that were regularly reviewed and tailored to their individual needs. These plans clearly outlined each person’s preferences, values, and wishes for their final stages of life. They also took into account any important cultural or spiritual practices, including religious beliefs, to ensure end of life care was delivered in a respectful and meaningful way.