Holcroft Grange Residential 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 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 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.

As some people’s care plans were not wholly accurate, and not everybody’s capacity had been assessed and recorded, we could not be fully assured the provider worked in direct partnership with people to respond to any changes in their care. A relative told us, “[Name] had an assessment when she first came here but not a formal review since.”

Some people’s daily care intervention records recorded people had taken a drink at the same time each day. These suggested records may have been completed retrospectively and not at the time of the care intervention and so did not reflect a person-centred approach.

Although staff were knowledgeable about people’s needs and the day to day care they required, daily care notes were not well documented and did not record much information about people’s well-being. Some people’s care plans lacked sufficient person-centred information personalised to the needs, risks and preferences of each individual. This aspect of care planning required improvement so that staff had clear information about people’s individual needs and preferences, and to help ensure people were involved in making decisions about their care.

However, people told us they had choices over their care and support. Comments from people included, “I can have as many baths as I want” and “I can please myself what I do - I don’t really have any restrictions. I get up and go to bed when I want."

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so we could not be sure care was not always joined-up, flexible or supportive of choice and continuity.

Processes in place to ensure all aspects of people’s care was integrated and co-ordinated were not fully robust. As people’s care plans were not audited, this meant assurances that the information they contained was accurate, person centred and up to date, were not fully in place. As some care plans contained inconsistent and inaccurate information, there was a risk care may not be as supportive of people’s choice or as joined up as it could be.

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

As some people’s care plans contained inconsistent information, we were not always fully assured people had been provided with information in a way in which they fully understood, as we could not be assured people had been fully involved with the care planning process.

However, some people’s care plans contained guidance for staff on the best way to communicate with people which aligned to the Accessible Information Standard. People’s personal information was kept confidential and stored in line with data protection legislation.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider used a variety of ways to enable people to feedback about their care and support. Written questionnaires were used, and meetings were held to help people encourage and express their thoughts.

We saw minutes of meetings, people discussed things which mattered to them such as activities they would like to participate in and menu options. One person told us, “They have regular meetings.”

The provider also held meetings for people’s relatives to enable them to have their say. Often meetings were held in an informal way – such as cheese and wine and hot pot themed evenings, to help people feel more comfortable to feedback about their loved one’s care and support.

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

Where people required care and support from external agencies and partners, for example, GP’s and dieticians, the provider recognised this need and ensured people had access to these services.

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.

Despite any limitations people may have had, the provider ensured people were able to access the support they needed.

The provider enjoyed positive relationships with an external primary care professional who visited the home on a regular basis. As a direct result of this positive working relationship, admissions into hospital had been prevented for people, as staff had worked alongside professionals to care for people at the home.

We could not be assured people were 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.

People’s care plans were either incomplete or did not capture sufficient detail to record people’s advanced wishes or end of life wishes. Some of the end-of-life care plans in place were quite generic and lacked detailed person-centred information. For one person who had a DNA CPR in place, their end-of-life care plan simply read ‘conversation with family needed.’

We could not be assured the provider had properly recognised and considered people’s values and wishes and how these may influence decisions about their end-of-life care. This is particularly important for people with a DNA CPR in place, to help ensure people had a pain free, sensitive and dignified death.