Rowanbrook 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.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 50 (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 their needs.

People told us they didn’t always feel their care and support was tailored to meet their individual needs and preferences. For example, 1 person told us they felt the environment enabled their personal preferences to be met. They said, “My room is nice but I would prefer somewhere to sit in a room which isn’t the same room as my bed is in. I don’t always like to sit with everyone else in the lounge.” Another person told us they would like to have more food that reflected their individual preferences and cultural heritage. They said, “The food is okay. I do get some [country they originated from] food here. Not often though but I do like it.”.

People also told us and we saw they were not always supported to engage in activities that were meaningful to them. One person said, “I would like to go outside though. I would like to sit under a tree and listen to the birds. That’s what I would like.” Another person said, “I’m not happy all of the time. I like dancing and music. There isn’t enough of that for me. There just isn’t enough to do.” We saw activities were promoted by an activity coordinator team. However, care staff did not always actively engage people in activities. For example, we saw 2 people with learning disabilities were given activities to participate in by care staff, but care staff did not actively support these 2 people to engage in these activities in a meaningful way. As a result, 1 person did not engage in the activity placed in front of them.

However, staff told us they followed the information contained in people’s care plans to provide care that was person centred.

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.

There was no underpinning policy or procedure in place to ensure the specific needs relating to people’s learning disabilities were considered and understood. This meant there was a risk the staff would not be responsive to their specific learning disability needs. For example, best practice guidance for people with learning disabilities was not followed to ensure any transitions through different systems of care were managed safely and effectively. For example, health and care passports were not in place to ensure reasonable adjustments had been considered and planned for during referrals and transitions to other services.

However, the information in people’s care plans around their physical health needs was kept up to date and was accessible. This ensured information could be shared with other professionals as required to promote consistent care.

The provider did not always supply appropriate information in formats that were tailored to individual needs.

Information was not always available in accessible formats to support people with their care and treatment. For example, people who may have benefited from an accessible version of their care plan to help them make care and support choices did not have these in place.

However, staff told us and we saw some information was presented in a more accessible format for those who needed it. One staff member said, “We use picture menus for those that can't verbally communicate. I sometimes write things down for people.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People and their relatives gave mixed feedback about raising feedback about the care and support. For example, some relatives described poor communication and barriers that meant they could not always engage in meaningful feedback conversations. One relative said, “When I ask for an update as to what they have eaten overnight to see if they have eaten anything, I just don’t get any answers. Communication isn’t good, they just can’t give me answers.” Another relative said, “I’ve asked to see the care plan, but I was told I have to make an appointment to do that.” However, another relative told us they had no issues with asking or giving feedback about care. They said, “I would talk to the nurse or the shift lead. I’ve never had to raise any concerns.”

However, group meetings with people and relatives were scheduled. Residents meeting minutes showed people were consulted with about some aspects of care such as food choices and we saw 1 person’s food request had been met as a result of this discussion. Relatives surgery notes shared with us showed 4 relatives had given feedback about care in the 12 months leading up to our inspection. Notes evidenced that changes to care were made in relation to 2 of the 3 feedback notes that contained evidence of concerns raised.

There was a complaints policy in place. The complaints record we viewed for the 1 complaint the registered manager told us they had received showed this policy was followed.

Effective systems were not in place to ensure all people could access the care, support and treatment they needed when they needed it.

Because no underpinning policy was in place to ensure best practice guidance was followed for people with a learning disability, we could not be assured people with learning disabilities would be consistently supported to access the services required to meet their specific learning disability needs.

People told us they were not regularly provided with the opportunity to access the community. Records we viewed confirmed this.

However, people and relatives confirmed support from health or social care professionals was accessed when required. This included access to emergency services. One person said, “I have seen a chiropodist here. I’ve also seen the speech and language team”. A relative told us, “[Relative] has fallen out of bed once here. They took her to hospital as a precaution.”

Records we viewed confirmed people were supported to access medical care at the right time.

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.

Care records and conversations with staff showed there were times when people with a learning disability were not treated or respected in the same way as other people their age. For example, a care plan for 1 person with a learning disability referenced that the person, ‘did not misbehave’. When staff told us about how they supported people with learning disabilities, some staff made reference to childlike behaviours. For example, comments included, “when they play up” and “[Person] turns their head around just like a baby does.” This meant people with learning disabilities were not always described with language that was appropriate for their age.

However, staff had completed training in equality, diversity and inclusion to raise awareness of potential inequalities. We were not assured this training was fully effective due to the concerns cited in the paragraph above.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Care records contained no evidence of goal setting or planning for important life changes. For example, at least 2 of the people who used the service had older parents who were very important to them. Care plans contained no evidence to show any planning was in place to support these people in the event of a parent becoming unwell.

However, systems were in place to promote responsive end of life care. Staff told us how they had supported people at the end of their lives. This included accessing anticipatory medicines to help manage end of life discomfort and supporting families to be present if appropriate. Staff confirmed they had received training in end of life care.