Ealing Manor Nursing 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.

This is the first assessment for this service since registered as a partnership in 2024. 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 relating to good governance (Regulation 17). The provider did not consistently demonstrate that people's feedback was effectively monitored, analysed and used to identify themes and drive service-wide improvement.

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.

The provider generally ensured people received person-centred care that reflected their individual needs, preferences and circumstances and involved them in decisions about their care and support.

Staff were able to describe people’s routines, preferences and support needs, and relatives gave examples of staff responding to individual requests. One relative told us, “If I needed anything or told them to make sure of something they always did.”

Care records contained information about people’s individual needs and preferences, although information about personal goals, interests and desired outcomes was less consistently detailed. There were also opportunities to strengthen meaningful activities and engagement. One person told us, “Activity, not a lot. Gets a bit boring sometimes.”

Overall, staff demonstrated a person-centred approach and knew people well. However, there were opportunities to further develop care planning and meaningful engagement to better reflect people’s individual interests, goals and what was important to them.

The provider generally ensured people's care was coordinated and continuous, reflecting their individual health and care needs and supported by effective working with relevant services and professionals.

People benefited from continuity of care provided by a stable and experienced workforce. The provider did not routinely use agency staff and many staff had worked at the service for several years. People knew the staff who supported them and one person told us, "Know most of the staff here," while another said, "I know all the nurses' names." These arrangements helped staff understand people’s needs, preferences and routines.

The provider worked with a range of health and social care professionals to support people’s needs. Staff described sharing relevant information when people transferred to hospital and professional feedback confirmed there was good communication and partnership working between the service and healthcare professionals. Healthcare professionals told us staff appropriately identified concerns, shared information and sought support when people's needs changed.

Relatives were generally positive about communication and described being kept informed about changes affecting their family members. Records demonstrated regular contact with healthcare professionals and staff worked with external services to support continuity of care.

The provider did not always ensure people received accurate, accessible and appropriately tailored information in a way that met their individual communication needs and preferences.

People’s communication needs were not always formally assessed or clearly reflected in care planning. For one person who did not speak English, staff described using information provided by relatives to support communication. The registered manager told us, “The family write for us and we show her and she points to what she wants from the list.”

Staff had developed ways to support the person to communicate their choices. However, there was limited evidence of a structured assessment of their communication needs. There was also limited evidence that other appropriate communication support had been considered. This reduced assurance that people’s individual communication needs were consistently identified and supported in line with the Accessible Information Standard.

People also questioned whether information provided by the service accurately reflected their experience. One person told us, "Booklet says feed the birds, where?" The provider explained that the birds had been relocated following infection prevention and control advice, but the booklet had not been updated to reflect this change.This indicated information about activities and opportunities available within the service was not always current or reflective of people’s day-to-day experiences.

However, staff knew people well and used a range of informal approaches to support communication. The shortfall related to the assessment, documentation and consistent provision of accessible information tailored to people’s individual needs.

The provider did not always demonstrate that people's views and feedback were consistently sought, analysed and used to influence their care or drive wider improvements across the service.

Some people wanted more opportunities to influence how the service was run. One person told us, “Meetings would be a good idea,” while another said, “I feel like talking to wallpaper.” Feedback about staffing, response times, activities and meaningful engagement was not always clearly identified as themes or used to inform wider service improvements. Although managers responded to some individual concerns, there was limited evidence showing how feedback was routinely reviewed to identify themes and learning across the service.

The provider informed us they had formal arrangements for gathering feedback, including annual resident and visitor surveys, annual activity surveys and the ‘Resident of the Day’ process to capture feedback from people and their families.

However, people and relatives generally knew how to raise concerns and gave examples of staff responding to their feedback. One person told us, “If I am unhappy I speak to manager,” and a relative said, “Suggested more [tabards] and they ordered them.” This demonstrated that individual feedback could lead to action, although there were opportunities to strengthen how feedback was collectively reviewed and used to support wider improvement.

The provider did not always ensure people had equitable and timely access to the care, support, information and facilities they needed.

Some people could not reach their call bells. We observed a person who did not have access to their television remote control because it had been placed in a drawer. This meant the person relied on staff both to summon assistance and to access an everyday item within their environment, limiting their independence and control.

Environmental barriers included bathrooms used for storage and areas without appropriate grab rails. Communication arrangements for people with language needs also relied on informal support rather than consistently accessible information.

However, people generally had access to healthcare services and specialist equipment when needed. The main concerns related to independent and timely access to support within the service.

The provider did not always demonstrate that it effectively identified, understood and addressed factors that could result in inequalities in people's experiences or outcomes.

Care records contained limited information about cultural identity, protected characteristics and equality-related needs, and communication support was not always formally assessed or reviewed. This meant the provider could not consistently demonstrate how equality-related information was used to tailor care and monitor people's experiences and outcomes.

However, there were examples of cultural and religious preferences being respected. One person told us, "The chaplain comes round to bless people," and a relative described staff providing culturally preferred food when requested.

These examples were positive, but the approach was not consistently reflected in assessment, care planning and monitoring.

The provider generally supported people and those important to them to plan for future changes in their health and care needs, including wishes and preferences relating to end-of-life care.

Records showed involvement from general practitioners, palliative care professionals and families when people’s needs changed or when planning future care. Staff worked with healthcare professionals to support people whose health had deteriorated and sought medical advice when concerns were identified. People had access to specialist support to help ensure care remained appropriate as their needs changed.

The registered manager told us that families could visit at any time when a person was receiving end-of-life care and explained, "They can stay overnight if needed." At the time of the assessment, the service was supporting a person receiving end-of-life care. Staff were able to describe how they monitored the person’s comfort and wellbeing and worked with healthcare professionals to support them.

End-of-life care plans were in place and records showed discussions had taken place with people and their families about future care wishes. Staff understood the importance of involving families and relevant professionals when planning care for people approaching the end of their lives.

Some future care documentation lacked personalised detail and reviews were not always meaningful. However, people generally received appropriate support from healthcare professionals and families when their needs changed, and arrangements were in place to support planning for future and end-of-life care.