Garsewednack Residential 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant people’s needs were not always met.

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.

Care plans had improved since the last inspection and included more detail, but several remained incomplete or lacked person‑specific guidance. For example, information on bathing and showering was not consistently recorded, and some people had no evidence they had been offered regular personal care in line with their assessed needs. One person’s diabetes care plan included generic instructions rather than tailored guidance.

Staff fed back that sharing information about people and changes had been improved. One staff member said, “WhenIcomein,I getupdatedon alltheclients, and they (Shift leader/ management) tell us what has beenhappeningfor them, and you check the documentationand whatthey like and need.” Staff knew people well, and relatives told us there were warm, kind interactions, but this was not consistently backed up through accurate or up‑to‑date records. Observations showed staff were kind and compassionate, but gaps in care documentation meant people were not always supported in a personalised or consistent way. These issues represent ongoing concerns which were also highlighted at the previous assessment.

There were some shortfalls in howtheproviderunderstood 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.

Opportunities for physical activity or daily stimulation were still limited. Most people sat down in the lounge in a chair or were in their beds all day. One person said, “Downstairs you see, they are just sitting there waiting to die, I’d rather wait to die in my room.”

Some aspects of integrated care were not yet fully embedded. Despite this, the service demonstrated consistent partnership working and improved responsiveness since the last inspection.

People had healthcare passports which gave clear information for external services, and staff made timely referrals to GPs and other professionals. We saw examples of staff responding to clinical guidance, including the use of thickener as recommended by speech and language specialists. Records showed regular GP involvement, and staff understood when additional support was needed. Staff reported morale had improved and felt communication within the team was better.

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

People were not always made aware of changes in planned activities, such as delayed sessions, which affected their experience. These gaps meant people and staff lacked reliable information to guide consistent and safe care.

The registered manager told us they were fully aware of the Accessible Information Standard. Since 2016, all organisations which provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get to receive information in a way they can understand it. It also says people should get the support they need in relation to communication.

The provider had started to think about how to make it easier 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, and they were not always kept up to date.

The activities programme was not always communicated clearly, meaning some people did not know when activities would happen, were not involved in changes in schedules or why schedules changed. People were not active partners in the development of their care and did not feed into decisions about the running of their service, despite Garsewednack being their home.

Staff knew people well, shared warm and meaningful interactions, and used humour sensitively. Relatives told us staff were kind and approachable. We saw people being supported in line with professional recommendations more, and staff were more open and responsive to feedback than at the previous assessment. People were able to raise informal concerns and staff felt more confident speaking up.

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

Opportunities to support people to stay physically active or go outdoors were limited, which meant some people did not receive equitable access to wellbeing‑promoting activities. Improvements had been made since the last assessment, but access to non‑clinical aspects of healthy living still needed development.

People had appropriate healthcare referrals, and staff acted quickly when they identified concerns. Staff understood the needs of people living with dementia or complex health conditions, and clinical support—such as GP input—was timely and well recorded.

People were supported to have visitors with one relative commenting, “Plenty of visitors and no restrictions.”

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.

Bedrooms were personalised and people felt respected and well‑treated by staff. Policies promoting equality and diversity were up to date, and people’s individual needs were understood better by the team. However, we found one person could not reach their call bell, meaning they did not have access to support when they needed it. We discussed this with the provider so they could ensure people being cared for in bed were treated equitably.

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.

Two people’s care records stated they were approaching the end of their life, but there was no corresponding planning, documentation, or personalised guidance to ensure their preferences would be met. There were gaps in end‑of‑life care planning for people whose care records referenced this stage of life, meaning this sensitive stage of support may not have been fully considered. Staff confirmed they relied on incomplete records, the lack of structured planning meant people’s future needs—clinical, emotional, and environmental—were not reliably anticipated or prepared for. These concerns represent ongoing issues from the last assessment that have not been addressed.