Carrington House Limited

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 inspection we rated this key question good. At this inspection, 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 and staff team did not always make sure people received person-centred care that was in line with their preferences, likes and dislikes. People’s care plans did not always contain information about how to support people with their specific support needs or listed generalised signs about the support need which were not personalised to the person. Staff were not always recording people’s care in a person-centred way. For example, there was no information about how at some times of the day people went for long periods of time without meaningful engagement. At some times of day, the environment was very overstimulating with televisions on, radios playing and staff trying to engage with people all at the same time, limiting the opportunities for individualised person-centred care. Staff did not have training to support some people living with specific health conditions.

However, staff were able to tell us how people liked to be supported and clearly knew people well. People and relatives were positive about how they were supported. One person said, ‘‘[Staff] are kind caring and patient. It can sometimes be a while between seeing them but whenever I do, they are smiling, and I can always call one of them to come and see me.’’ A relative told us, ‘‘I am very happy with how staff treat [family member] and I would say the service is very person centred.’’

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. Staff understood and respected people’s cultural support needs, in relation to the food they chose to eat and the religious practices they wished to follow. The management team organised for partners in the community to come into the service and spend time with people such as local entertainers and local schools. The staff team was consistent, so people knew who was supporting them and had good continuity of care. One person said, ‘‘The staff try and take me out as much as they can. I like to get out and go shopping and buy chocolates.’’ A relative told us ‘‘I like the fact that whenever we visit, we always see the same [staff] faces. [Family member] knows them all well too.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Whilst, forms of communication such as pictures and objects were available to support people, we did not see these used by the staff team to support people. People would have benefitted from using these to help them communicate. The registered manager acknowledged this was an area they could improve on in relation to documents being available to people in an easy to read and understand format.

However, we observed staff speaking with people in a slow and relaxed way to help make sure people understood what was being communicated with them. People and relatives were invited to meetings to discuss what was happening at the service so information could be shared with them. Staff had daily meetings to discuss how people’s support needs may have changed or any other information they needed to know. One person said, ‘‘We go to a meeting every now and then and [registered manager] tells us what is going on.’’ A relative told us, ‘‘We are invited to meetings, but we have an informal chat with the staff who let us know any information when we visit.’’

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. People were invited to feed back in meetings at the service however these were only attended by a small number of people who were able to feedback verbally, easily. People who communicated in other ways or chose not to attend the meetings were not being supported to feed back about the service in a meaningful way. The registered manager responded to this feedback immediately and put measures in place for feedback to be collected from people who needed this support.

Other people fed back about the service in regular meetings. People and their relatives were given the opportunity to be involved in discussing care plans and risk assessments. One person said, ‘‘I think staff are patient and they do listen.’’ A relative told us, ‘We look at [family member’s] care plan regularly and discuss if any changes are needed.’’

The provider made sure that people could access the care, support, and treatment they needed when they needed it. Staff supported people to contact health professionals such as GP’s or speech and language therapists if necessary and supported them to attend appointments with these professionals. Professionals were positive about how the staff team worked with them to support people.

People’s experiences and outcomes were not always positive or consistent. It was unclear how people were being supported to discuss what outcomes they wanted to achieve or how staff were supporting them to achieve these. It was also unclear how people were being supported to follow their identified interests and pastimes. Whilst there were opportunities for people to be involved in social engagement, this did not always interest people. One person said, ‘‘I find it quite childish [downstairs] and what’s on offer isn’t really my cup of tea.’’ As a result of sometimes going longer periods of time without staff interaction or not being consistently supported with dignity and respect of offered meaningful choices, people’s experiences at the service were sometimes not as positive as it could be. The management team were responsive to our findings and sent us assurances they were starting to address this with the staff team.

However, we also observed some people to enjoy the social past times of offer such as playing bingo, going out for coffee, or completing arts and crafts and listening to music. One person said, ‘‘There is always something to do here.’’ There was also evidence some people had experienced good outcomes. For example, maintaining skin integrity whilst being supported at the service. One relative said, ‘‘[Family member] spends their time in the communal areas and always seem to be busy. I think this helps them to feel good.’’

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 care plans contained detailed information about how people would like to be supported at the end of their life. Staff had a good understanding of how to support people with dignity and respect at this time and who to contact for further help if needed. One relative said, ‘‘We would want [family member] to spend the rest of their days here and trust the staff would give them the best care possible.’’