Bowes House

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 Good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People told us, “They do talk to me about most things, but I can also tell them what I don’t want, to be honest, I don’t like fuss. Staff listen and change certain things if I struggle or am not happy,” “They have literally been so lovely, they know me so well even though I have not been here that long,” and “I know I have a care plan that they discuss with me.”

Everyone had a pre-assessment before moving into Bowes House Residential Care Home to confirm that the home could meet their expectations, wishes and needs. On admission, staff recorded each person’s preferences, a life history and completed a history of their life section This helped staff build positive relationships with people as they settled in.

Care plans reflected people’s individual needs, routines and preferences. Staff understood how each person wanted to be supported and used this information to provide personalised care. Records showed that people and, where appropriate, their relatives were involved in care planning and reviews when needs changed. This was confirmed by families. One visitor said, “They involve me, I feel my views are taken into consideration.” We did share some feedback with the management team regarding a family saying it would be helpful to have a named person they could contact with queries and for support. There was a key worker system, but this had stalled due to staff changes. The registered manager said she would arrange a meeting and take this forward.

Staff supported people with consideration and respect for their individual needs. For example, people spending time in their rooms appeared comfortable and were surrounded by personal belongings. Staff played their preferred music or television programmes, interacted positively with them and used their preferred names. At mealtimes, people chose where to sit. Staff provided prompts or assistance with eating when needed and supplied adapted cutlery where appropriate.

People said they were involved in decisions about their care and daily lives, those that couldn’t tell us, had information within their care plan of how decisions were made, for example, family and social worker involvement. Relatives reported that things had improved over the past few months and communication from the home team had improved.

Activities that enriched people’s lives were an important part of life at Bowes House Residential Care Home. The activity team were enthusiastic, engaging and knew people well. They organised entertainment that was enjoyed by people and which people could participate in, they also did evening activities and visited people in their rooms. Relatives were all positive about the social events and talked of regular events that people looked forward to, such as singers and bingo. This enabled people to take part in meaningful activities suited to their needs, preferences and abilities. Visitors told us, “Always something nice happening.”

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.

Staff worked with families, recorded appointments and advice, and kept relatives informed. Care plans reflected people’s assessed needs, routines and support arrangements and were reviewed when needs changed. Handovers, care records and daily communication kept staff informed of people’s current needs, preferences, risks and changes in presentation.

Recent safeguarding investigations have identified a need to develop stronger communication and information sharing systems regarding input from other health professionals involved in peoples’ care. The registered manager showed us what had been learnt from these safeguarding concerns so far and how they had used initial information to improve both communication and information sharing.

The service worked with relatives, unpaid carers and external professionals to maintain continuity of care. Records showed people accessed healthcare when needed and relevant information was shared to support joined-up care. A health professional said, “Staff have always been professional and polite. They appear to know residents well and contact us when needed. We have noticed that there has been a definite improvement in communicating with us.”

Staff understood the Equality Act and described how they supported people fairly in care and decision-making.

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

People’s communication and information needs were assessed before admission and recorded within their care plans. People and their relatives, where appropriate, had access to their care plans. Staff were trained and aware of General Data Protection Regulations principles.

This approach helped to ensure people’s communication needs were known and met in line with the Accessible Information Standard (AIS). The AIS is a framework, making it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand the information they are given.

We saw that staff supported people to remain in touch with family and friends. One person used a video call set up on their mobile that staff ensured was in reach when the family called. We also saw within care plans, instructions for staff to follow regarding hearing aids and eyeglasses.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Most people told us they were asked for their views and felt listened to. However, some unresolved complaints were still being addressed. One of which is part of a local authority safeguarding due to the complexity of the complaint.

Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions proposed and taken were then discussed at the next meeting. There is a communication board that stated what’s changed or happened as a result of feedback. There was a wishing tree in the reception area that people were asked their dearest wishes. One person wanted to watch his football team play at the home ground. Staff listened and this was achieved and thoroughly enjoyed. We saw that people were supported to make plans to help them achieve these goals.

There was a complaints policy and procedure, we saw that concerns raised had been responded to promptly and thoroughly. The management team kept a log that ensured the manager had an overview. They told us they had an open-door policy, relatives told us, “I would just go to the office or find the nurse, always someone around.”

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

Relatives told us their family members received care and support, which was accessible, timely, and considered their individual needs. There were people who shared their barriers and one of those was a lack of appropriate specialised wheelchairs following discharge from hospital to allow them to leave their bed and join in activities or visit the garden. The person and their family told us that it was due to external priority and to a long waiting list. They had purchased one but it was not totally suitable but could be used safely for short periods of time. The registered manager was continuing to chase on the persons behalf and had contacted the appropriate agencies to find a solution.

Staff were aware of any reasonable adjustments people needed to engage fully into life at the service and to access community activities. Staff were able to discuss ways they supported people to live the life they wanted; food was specifically adjusted to meet people’s needs, so they could eat the same as everybody but in a way that was safe for them, such as pureed and minced.

Staff recognised the importance of people not facing barriers to access health and social care services and professionals provided positive feedback about how well staff worked with them.

All areas of the home were accessible and adapted to allow wheelchair users to use them including bathrooms and the garden.

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.

People living at Bowes House had a range of needs relating to mobility, communication, cognition, health conditions and sensory needs. Staff were able to discuss and demonstrate an understanding of people’s differences. They told us how they adapted their approach so people could be involved in daily life and receive care in a way that worked for them.

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.

Staff worked closely with people to plan their future care. People and their families were involved in decisions about end-of-life care and how they wished to be supported. Recognising that some people found these conversations difficult, staff gathered information gradually and added relevant details when it was appropriate.

Care plans recorded people's end-of-life preferences and, where this was their wish, the service coordinated palliative care within the care home. They also included guidance on people's religious beliefs and resuscitation wishes. Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms were in place for most people to help ensure personal wishes were followed. People also had Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, also known as Do Not Resuscitate (DNR) orders, which were accessible to staff and healthcare professionals when needed. Staff discussed DNACPR and ReSPECT forms with people and their families, ensuring they understood their options and the implications of withholding or withdrawing treatment to support a dignified death. Relatives and friends were supported compassionately during this difficult time. For example, visiting arrangements for people approaching the end of life were extended.