Solent Grange 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 registration under the new provider. 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 in relation to governance. This was because systems for assessing, planning and reviewing care were not always effective.

This service scored 54 (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 any relevant changes in people’s needs.

We identified inconsistencies in person-centred recording within care plans. Some records contained duplicated information, including references to other people using the service, indicating lack of robust individualisation within care planning documentation. This meant care records did not consistently reflect people’s unique needs, reducing assurance that care planning was fully person-centred.

Feedback from relatives was mixed. Some relatives described care as personalised and tailored to individual needs, while others described care as more task-focused or functional. This demonstrated variation in people’s experience of person-centred care depending on individual circumstances.

However, we observed staff delivering care in a person-centred way during the inspection. Staff interacted positively with people, adapted communication approaches and supported individuals in line with their preferences. People appeared comfortable with staff and engaged positively in conversations and daily activities. One person told us, “The staff know me very well and I am well looked after.” This demonstrated that, in practice, staff generally understood people’s needs and preferences, supporting person-centred care delivery.

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.

Relatives raised concerns about communication and continuity of care, particularly in relation to language barriers and consistency when agency staff were used. One relative told us, “With encouragement from the right member of staff, [Person] will be guided,” while another told us, “I don't think many really know [Person’s] likes and dislikes.” A person also told us that agency staff did not always know them as well as regular staff. This demonstrated variability in continuity of care linked to staffing consistency.

However, the registered manager had taken some steps to promote continuity, including using a consistent group of agency staff and discussing continuity of care in team meetings. Managers also explored ways to improve continuity while balancing staffing pressures. This demonstrated some awareness of continuity risks, although experiences varied across the service.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We found that information was not always accessible to all people. One person whose first language was not English told us, “I find it hard to communicate with staff, but they do their best.” Although alternative formats were discussed with the registered manager, including pictorial aids, this had not been consistently explored prior to inspection feedback. This meant people may not always have received information in a format that supported understanding and engagement.

The provider had policies in place relating to accessible information standards and General Data Protection Regulation (GDPR). Staff told us they could provide information in alternative formats when requested, and an example was provided of a person receiving large-print activity schedules. However, the provider could not always demonstrate that accessible communication needs were proactively assessed and met for all people, particularly those with cognitive or communication difficulties. This meant that the Accessible Information Standard was not consistently embedded in proactive practice.

Despite this, some people and relatives reported positive communication experiences, including being contacted by staff when decisions needed to be discussed and receiving information in ways they could understand. This demonstrated that while individual examples of accessible communication were effective, provision was not consistently embedded across the service.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Systems were in place to record complaints and feedback, but there was limited evidence that learning from feedback was consistently embedded. Themes identified in staff surveys and resident meetings, including staffing shortages and laundry concerns, were not consistently addressed or closed through clear action plans. This meant that feedback mechanisms were not consistently translated into service-level improvement actions.

Despite this, people and relatives told us they felt able to raise concerns and were confident these would be listened to. One relative told us, “I have raised complaints, and they have been dealt with as best as they could.” This demonstrated that people generally felt able to speak up, although evidence of systematic learning from feedback was limited.

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

People generally had timely access to care and support when required. Care records showed people received support in line with their assessed needs, and an on-call system was in place to respond to out-of-hours requests. This demonstrated that systems were in place to support timely access to care.

People told us they felt staff responded flexibly when they needed support outside of routine hours. This ensured people could access care when required, supporting their safety and wellbeing.

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.

We found variation in the opportunities available to people depending on their level of mobility and engagement. People who were more mobile had access to a wider range of activities, while people who were cared for in bed had fewer recorded interactions, including limited activities such as brief chats or personal care tasks.

One person expressed a wish to access community activities such as visiting a library, however they told us that they had not been supported to do so. Relatives also raised concerns that people who were cared for in bed had fewer opportunities for engagement. This demonstrated inequality in access to meaningful engagement based on care dependency level, increasing the risk of social isolation for some people.

People were not always 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.

Care plans included Do Not Attempt Resuscitation decisions and some information about hospital admissions, however, end-of-life wishes were not always fully documented or discussed. One person’s end-of-life care plan indicated they were deteriorating with a limited prognosis, but discussions were deferred with no evidence of follow-up. Relatives and people told us they were unsure whether end-of-life planning had been discussed. This meant people were not always supported to plan for future care in a timely or structured way.

Despite this, where discussions had taken place, care records reflected people’s wishes and preferences. The service also held accreditation in end-of-life care, and relatives provided positive feedback about the quality of care provided at the end of life. This demonstrated some areas of good practice, although this was not consistently applied across all people.