Royal Leamington Spa 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.

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.

This service scored 61 (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 and their representatives told us staff treated them with respect and kindness and took a person‑centred approach to their day‑to‑day care. Relatives were positive about the support provided. One relative said, I would 100 per cent recommend them. They are wonderful. It took a while for [Name] to trust them, following a bad experience in another home, but now they most certainly do." Another relative said, "I have high expectations, I know how things should be done. But they often remind me that [Name] has capacity and needs to be involved in the decision making too."

Many people living in the home had previously lived with other care providers and told us they now felt happier and safer at The Royal Leamington Spa Nursing Home, which many affectionately referred to as, ‘The Royal.’ Despite the concerns we found around risk management, the environment, record‑keeping and governance, people consistently told us that staff delivered care in a way that felt personal, responsive and not task‑focused.

The registered manager told us they were committed to providing high‑quality, person‑centred care and felt supported by the provider to increase staffing levels or purchase equipment when needed. This helped ensure the service could continue to meet people’s individual needs and preferences.

These examples showed that people experienced care that reflected what mattered to them, and staff worked in a way that promoted dignity and trust.

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.

The provider reviewed local healthcare needs to ensure the service was developed in line with what people wanted and what was available in the community. People were supported to access help from other health and social care professionals, and referrals were made to specialist teams when required. Commissioners of care gave positive feedback following their visit in December 2025, and a visiting health professional told us they felt people received good care.

Staff worked with external professionals to ensure people’s health needs were met in a timely and coordinated way. Weekly GP visits and ward rounds helped ensure people’s conditions were monitored and any concerns were addressed promptly. The provider also supported people to access available funding to help meet their care needs, ensuring people received the level of support they were entitled to. These arrangements helped ensure people received appropriate, coordinated and effective care.

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

People did not always have access to clear or accessible information to help them understand and navigate the service. There was no signage around the home to help people identify where they were, and not all bedroom doors were labelled with names. This made it harder for people, particularly those living with dementia, to find their way around.

Key information such as how to make a complaint, minutes of residents’ meetings, the service user guide and survey feedback was not available in accessible formats. Activity staff told us they would read meeting minutes to people on request, but this relied on people knowing to ask.

A written menu was displayed in the entrance lobby, but it was not accessible to people living in the home. Activity staff said they verbally told people what was for lunch each morning and recorded their choices, but people did not have the opportunity to view the menu themselves. Monthly activities were listed on a whiteboard on the ground floor, but again, this was not accessible to the many people who spent most of their time in their rooms. No pictorial or easy‑read information was seen around the home.

Information shared with relatives about changes in the home was sometimes delayed and not always accurate, which meant families were not consistently kept up to date. These issues meant people did not always have the information they needed, in a format they could understand, to make informed choices or feel fully involved in their care.

CQC requires that providers display their rating from us on their website, and that the link to our report must be easy to find on the home page and not hidden or require scrolling. The provider did not make the link to our report accessible and easy to find.

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.

People’s care records were reviewed monthly by the nurse on shift. We found that these reviews did not usually involve people or their representatives, and many people and their representatives told us they had not seen their care records or knew what was contained in them.

The registered manager held monthly relatives and residents’ meetings, but not everyone was able to attend due to mobility, health or personal preference. The registered manager told us they also spoke with people individually in their rooms to gather views, but there was no recorded evidence of these conversations, so it was unclear how people’s feedback was captured or used to improve the service.

An annual survey was completed in December 2025 for people who had lived in the home for more than a month. Following the survey, the registered manager had produced a 36‑page report summarising the results. The report contained a lot of data and numerical scores. Where areas had scored lower in the survey, there was little information about what actions would be taken to address these concerns. The language, format and level of detail in the report meant it was not accessible or meaningful for most people living in the home. These issues meant people were not always fully involved in shaping their care or the running of the service, and feedback was not consistently used to drive improvement.

However, we saw many thank‑you cards and examples of people expressing appreciation for the care they had received, showing that when support was delivered well, it was valued .People told us they would usually speak to the deputy manager if they had a concern. One person said, “I would speak to (deputy manager) she has something about her that makes you feel safe.” Another person said, “I would talk to the deputy manager, she is approachable.”

Staff said that if someone raised an issue, they would try to resolve it or help them to escalate their concern through the formal complaints process.

The provider made sure that people could access the care, support and treatment they needed when they needed it. There was a range of equipment in place to support people to mobilise and move around the home including lifting mobility equipment and wheelchairs.

Managers and staff understood how to support people to access external healthcare services. Staff monitored people for any changes in their health and acted promptly when concerns were identified. We saw that referrals had been made to wheelchair services, dieticians, dentists and speech and language therapists when required. This helped ensure people, including those with protected characteristics, could access the services and support that were important to them.

People’s religious needs were also respected. Bible classes and church services were organised within the home, enabling people to continue practising their faith if this was their preference.These arrangements helped ensure people had fair and timely access to the support, treatment and opportunities that mattered to them.

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.

How people’s health conditions could impact on their experiences had not always been fully considered. We found that some areas of the home had not been adapted or assessed to ensure they met the needs of people living with dementia or cognitive impairment. For example, there were no pictures or visual cues to help people recognise their bedrooms, and there was limited signage to support people to find their way around the home. This may increase confusion or make it harder for people to feel confident and oriented in their environment.

In the lounge, a doorway had been blocked off. From the reception side it still looked like a door. The doorway had been decorated with a flower arch, to make it look inviting, but it could not be opened. Inside the lounge, the blocked doorway had been covered with a very large mirror. This is not considered best practice for people living with dementia, as it can cause additional confusion or distress.These environmental issues meant the home was not fully supporting people’s independence or ensuring the environment was as accessible and dementia‑friendly as it could be.

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.

Records did not always demonstrate managers, and staff had helped people and their families explore and record their wishes about care at the end of their life and how these were to be met. We looked at a care plan for 1 person who was on an end-of-life pathway. The person had a ‘Death and dying’ care plan that said ‘I have end of life wishes’ but there was no description or information to tell staff, what they were. We discussed this with a leader in the home who said, “There are no risk assessments either around end of life. The records say there is an advanced care plan but there isn’t one.” The staff member explained that the person’s relative had not completed it, yet there was no follow up or reminders to obtain this important information. We were shown this person had a RESPECT form that records a person’s preferences for clinical care and treatment in an emergency, particularly if they cannot make decisions. It was last completed in 2020 and was about COVID-19. No consideration had been given to reviewing it to ensure it remained relevant and still reflected the wishes of the person or up to date clinical advice.