Friary 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

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.

Documents were not reviewed to ensure they were accurate, and person centred. Care plans did not always include people's goals, life history, or longer-term aspirations. Care plans did not always include personal preferences, likes and dislikes. For example, personal preferences regarding food. This put people at risk of not receiving care that reflected their needs, wishes or preferences.

The provider did not follow best practice guidance to assess how each person living with dementia could orientate themselves in their surroundings. People lived in a communal environment that was not dementia friendly. Despite providing care for people with a diagnosis of dementia, the provider did not follow best practice principles in respect of the environment. For example, there was no evidence of adaptations to the environment to make it more stimulating and appropriate. There were no items to help people orientate and navigate their surroundings. All bedroom doors were painted white and had only a number on them. There were no memory cabinets with significant personalised items or signage to help people orientate and locate the lift, kitchen, communal bathrooms or dining room and no contrasting colours had been used to aid visual perception. In addition, communal bathrooms were used to store moving and handling equipment. The provider did not follow best practice guidance, such as from the University of Stirling’s Dementia Services Development Centre, to remove clutter to make frequently used items easierto see and minimize trip hazards.

The registered manager explained to inspectors that they were not aware of the importance the design of the environment had on people living with dementia. This meant that people were not being supported in a way that could ease anxiety and maximise their independence and quality of life.

The provider understood the diverse health and care needs of people and their localcommunities, so care was joined-up, flexible and supported choice and continuity.

Overall, people and relatives provided positive feedback regarding the care at Friary House. A relative told us, “Yes, low staff turnover so they know the residents and families really well. They care for [relative] so well.” A staff member told us, “We haven’t used agency as long as I have been at Friary as this system works well, and residents know who are looking after them which builds trust”.

A healthcare professional told us, “Management are responsive to our advice and / or concerns.”

The home had a low staff turnover rate and did not use agency staff. This enabled people living at Friary House to be supported by a regular staff team.

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

There was mixed feedback regarding relatives’ involvement with care planning and reviews. A relative told us changes in medication, health or everyday issues was not always communicated. A person told us that they had not seen their care plan, however another relative told us that they had been involved in care planning and reviews.

A staff member said, “If someone is not very good at communicating choice we would hold clothes up for them to choose from so they can point or blink or just shake their head”.

The activities planner was not on display for people living at Friary House to see what activities were available and to choose if they wished to partake in the activity. Staff told us that they were normally on display, but they were behind at the moment. The activities planner only used words to explain what the activity was and did not contain pictures of the activities to support people to easily understand.

The provider had not met the requirements of the Accessible Information Standard. The Accessible Information Standard (AIS) isa legal requirement in the UK to ensure individuals with disabilities or sensory impairments receive information and communications in a format they can access and understand.

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.

We found no evidence that people were having the opportunity to provide formal feedback on the service they received. For example, through meetings, surveys or questionnaires. This meant that people were not involved in the shaping of the service or assessment and delivery of their care and support. This increased the risk of people not having all their needs met in accordance with their wishes and preferences.

A staff member told us, “All residents are given options about their care, and it is very person centred. This can be from their brand or type of tea to days out, or their own time and schedule for things like personal care and meals.”

Relatives mostly told us that they could speak to the management team at Friary House if they needed to.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Professionals generally told us that the provider works well with them, contacts them and follows the advice they provided, and staff members told us they had contact with the district nursing team. However, we found inconsistencies in referrals being made for people when required. For example, whilst community nurses were supporting people with pressure care there had been no referral made to healthcare professionals for a person living with contractures.

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.

The training matrix showed that not all staff had completed training in diversity and equality in line with best practice. Care plans were not sufficient, clear and concise to enable staff to provide person centred care. The review process did not evidence people or their relatives had been involved in the care plan review. As a result, decisions were made for people without consulting them and care could become less person centred.

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.

Peoples care plans lacked person-centred details in regards to their individual goals and aspiration and people were not always involved in reviews for their future plans. End of life care plans had not been devised for people. With no plan, people could experience end of life care that was not in accordance with their wishes and preferences. This risked them not experiencing a good death. Not all staff had completed end of life and palliative care training. The training matrix showed that not all staff had completed training in end of life and palliative care in line with best practice. One relative told us they discussed their relatives end of life preferences. Staff, though not always trained, showed empathy and told us, “We see residents into Friary House, and when it’s their time to pass we stand in the hallway and say goodbye and to fly high.”