Royal 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 service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people felt. This meant generally people’s needs were met through good organisation and delivery.

The service was in breach of legal regulation in relation to the good governance of the service.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service generally 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.

During observations at Royal care home, we witnessed person centred care was being provided. Relatives felt people received person centred care that met their needs, one relative said, “I think they are good at providing person centred care.”

Overall, the care plans were generally person-centred based on the information recorded, however there were inconsistencies in documented information and issues with managing risks and monitoring, meaning further work could be done to improve this. Staff spoke about what person centred care means. One staff member said, “(It’s) How the person wants to be cared for, what they want to happen."

The service understood the diverse health and care needs of people and their local communities, care was mostly joined-up, flexible and supported choice and continuity.

One relative told us they were happy with the care provision. They told us, “It is value for money as they have taken a whole lot off my shoulders and I feel confident in his care, I am not shy if I wasn’t happy, I would be there telling them, I would feel confident in them. He may have a fall but up to now I am happy he has never fallen.”

Throughout the inspection staff and management made reference to various organisations they made referrals to for support when needed. We found examples where referrals were made to ensure people received the right support and treatment.

Professionals provided mixed feedback in this area. One professional told us, “Yes they would contact social services to review care needs and consider if increased care is needed, they would implement increased obs (observation)/support/1:1 in the interim to protect patient and others.” Whilst another said “The continuity of care may be questionable at times as there was no conclusive evidence of establishment of all the care plans provided. This was not the case all the time.”

Although the service could supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs, we found people’s records were not always appropriately stored.

People’s information was protected using passwords on electronic devices. However, we found some people’s historic notes from visiting professionals was in an unlocked cupboard at the entrance which could be accessed by anyone in the home. The registered manager removed these after we made them aware of this issue. A GDPR policy was in place, but this was not always being followed.

People could access information and could express their views in numerous ways including at resident meetings, through surveys and by raising complaints. People and their relatives felt their information was securely stored. One relative said, “They keep the information on electronic devices.” Staff spoke about how they promote people’s privacy.

The registered manager spoke confidently about how they could make information accessible for people. They told us, "It is about making sure people have access to information by following GDPR. We can put it in different ways like pictorial and easy read, braille and things like that. We don't have anyone that needs that thought at the moment."

Pictorial menus were available to support people that may need this type of visual imagery.

Although the service made it easy for people to share feedback, action was not always taken promptly.

Staff told us they generally felt able to escalate any concerns to management to investigate, but that they were not always proactive. One staff member said, “I feel like when I have raised issues about staff not doing things, it hasn't been acted on straight away. (they are) Quite slow at getting things resolved.”

Some surveys had been completed by people and their relatives in January 2024, responses were mixed about the home and care and some responses indicated that the environment needed to be improved. Whilst some improvements in this area had been made, there was still significant work to do, and improvement was not being made at any pace. We saw evidence of further invites for visitors to complete surveys but there had been no responses.

We reviewed a complaints log and this had one complaint recorded, which was promptly responded to. Policies were in place to support people sharing feedback, including a complaints policy. People and their relatives were able to raise concerns or feedback through various channels. One persons relative said, “They encouraged us to talk to them, if we had any problems or queries.”

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

People and their relatives felt the home was accessible. One relative said, “There is a ramp at the front and the front door is a double door for easy access.” Although the home was accessible via ramp and there were some ground floor bedrooms, the service did not have a lift. There were 2 stair lifts that took residents upstairs, however one floor had a small number of steps that was not covered by a stair lift so this made it difficult for some people to access all areas of the home. The registered manager told us they had only placed people in this area that were more stable on their feet. When inside, the corridors on the ground floor were wide making it suitable for wheelchair users. The service had equipment in place to support accessibility in the home. Professionals felt the home was accessible for people and they also noted that they were able to easily contact the home.

People could access care and support when needed. Staff generally felt that people received the care they needed.

Staff and leaders listened to information about people who are most likely to experience inequality in experience or outcomes.

A family member told us they felt people are treated equally. Staff told us they had no concerns about the care the service provided. Meetings for/with residents were taking place, and newsletters were sent to loved ones, which kept people up to date with any changes and allowed them to discuss any concerns.

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.

People’s relatives told us that people had end of life care plans in place, one relative said, “Yes, they have an end-of-life plan in place for her.” The registered manager told us how they support people at the end of their life. They told us “They (staff) carry out end of life training and I have an end-of-life champion. He attends all the funerals, and he has an end-of-life board (in the staff room).”

We saw evidence that people had appropriate records in place if they did not wish to be resuscitated. We found some people had end of life care plans in place, where it was their wish to discuss this.