Badby Park

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.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 46 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership to ensure peoples person-centred needs were always met.

People did not always receive person centred care to meet their individual needs. For example, we found one unit to have a blanket approach to the settings on people’s pressure relieving equipment instead of setting it to people’s individual weights to prevent pressure sore development. This increased risks to people.

People had their hobbies, interests and activities they should be encouraged to take part in recorded in their care plans for staff guidance. However, care records did not evidence that these happened for people. For example, one person’s care plan advised of the activities that they used to enjoy and to offer trips away from the home to pursue this activity, there was no evidence this had happened. There was evidence that the person had been offered repeated group activities that despite being clear of their disinterest was not offered a person-centred activity as per their care plan. Another person had a person-centred activity as a condition of their DoLS, this activity was taking place for people on other units but was not offered to this person, and there was minimal evidence that the person had been offered other activities detailed in their care plan.

A staff member told us, “My unit is very ‘task orientated’ to the detriment of our residents. Very little spontaneous activity is done. I do appreciate the unit is difficult with the staff levels and residents conditions, but a little empathy, understanding would help”. A relative told us, “Badby Park use to have a great reputation, it doesn’t now, the activities are few and far between”.

There were some shortfalls in how the provider understood the diverse health and care needs

of people, so care was not always joined up or supportive of continuity.

The provider employed an in-house therapy team including physiotherapists, a dietitian, occupational therapists and speech and language therapists. This provided continuity for people needing access to these services and the ability for staff to seek support promptly from these professionals. We were not consistently reassured that the therapy team skills were best utilised as they were used to make up staff numbers to support with activities and provide an extra pair of hands at mealtimes.

There were regular teams of staff that new people well and had access to care plans. However, this did not mean that person-centred care was always delivered as planned. A relative told us how their family member required a limb support to be in place but this did not always happen. When the relative raised the issue it would be resolved for 2 to 3 weeks then the same issue would arise. The relative told us, “[Staff] always apologise and say it is due to their shift processes; this is because their shift change over occurs midweek and things don’t get handed over to the new team.”

We observed people who were funded for 1 to 1 staffing support were received this.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider understood the accessible information standard. The Accessible Information Standard requires NHS and adult social care providers in England to ensure that people with disabilities or sensory loss receive information in accessible formats and appropriate communication support so they can fully understand and participate in their care.

Information was provided for people in a way that they understood. For example, providing information in large print, other languages or the use of technology. A relative told us about and we saw a person using technology to maintain contact with family at home.
We saw that where people needed information in a particular way such as large print or pictorial this was recorded in their care plans. Staff understood the need to communicate well with people. One staff member said, “I communicate clearly with people, using words, gestures, or pictures if needed.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The provider arranged resident and relative meetings, not all relatives knew about the meetings and not all could attend due to distance or other commitments. Although some relatives got copies of minutes an effective system was not in place to ensure everyone received a copy of these. One relative told us, “Never received any minutes of the meetings”. Meetings had not been held via an alternative method such as a video link to ensure everyone could attend.

Information of how to raise a concern or make a complaint was displayed around the home, however, people had a mixed experiences from raising a complaint. A relative told us, “I had a meeting with the registered manager, they did listen to me, but I felt nothing was going to change, and it hasn’t. That was 18 months ago now.” A staff member told us, “I once supported a relative to raise a concern about mealtimes, and the menu was adjusted to meet people’s preferences.”

The provider did not always make sure that people could access all areas of the home.

The grounds of the home were unkempt and created some potential tripping hazards from discarded building materials and overgrown foliage. A relative told us, “It would be nice if [relative] could go into the garden, but you can’t really, at the open ends [of the pathways] there is dumped old machinery and dropping apples, so very hard to manoeuvre a wheelchair.”

People accessed communal areas via lifts and ramps and there were adapted bathrooms available.

People had access to health care appointments as and when needed but access to other services such as a hairdresser or trips outside of the home had not been available to all.

Staff and leaders did not ensure people received equity in experience and outcomes.

People did not have equal experiences across the home. There was a manager on each unit, however, it was apparent that the service operated in silos which meant that the people had different experiences depending on which unit they lived. For example we found one of the units to be homely with a pleasant communal area and a lounge set out to support interactions and community. However, a different unit had a hospital ward environment that was starkly decorated and furnished with chairs set along a corridor as the communal area. The registered manager started to make some changes to this unit at our following visits to try to create a more inviting feel.

Although there were rehabilitation facilities including a gym, home skills rooms and a hydrotherapy pool there was little evidence of these being in regular use or available to everyone. For example, one person had a particular love of a sporting activity that could take place in the gym but we saw no evidence they had been assessed to use it.

Relatives told us that peoples experiences were different. One relative said, [relative] used to go out for coffees at [local business], this stopped a few years ago.” Another relative said, “[Relative] goes out from time to time to the shops accompanied by a carer.” A staff member told us that access to transport and a driver was very limited, hospital appointments are first.”

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.

People had advanced care plans as part of their planed care. However, they were found to be generic and focused on people’s DNACPR (Do-Not-Attempt-Cardiopulmonary-Resuscitation) status and advised staff to maintain privacy and dignity, contact next of kin and provide pain relief to keep them comfortable. There was no person-centred information or guidance for staff such as if they would want to see a leader from their faith, would they want to be admitted to hospital, or if they would find touch comforting.

Records evidenced staff had completed training in end of life care but we were not assured they were competent in advanced care planning.