Trafalgar Care Home

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• 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.

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

This service scored 62 (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 always 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.

At our last inspection we found staff had not always been given instructions to provide personal care such as assisting people to shave. At this inspection we found improvements were made to provide more detailed guidance to staff on how to deliver personal care to people and how to approach them when they refuse support with personal care. However, evidence still showed shortfalls in person-centred care and further improvements were needed. People’s care plans were focused on their healthcare needs and lacked person centred details. We found very little information about people’s personal life history, wishes and preferences, passions and hobbies, cultural background and spiritual beliefs. Care plans were not always developed in close collaboration with people and others important to them. Care planning was focused on people’s current medical needs rather than each person’s whole life, including their goals, skills, abilities and how they prefer to manage their health.

People had opportunities to discuss their interests and hobbies at residents’ meetings. This information was used to help plan social events and activities. However, information gathered was not always included in people’s care plans. We found no evidence staff took account of people’s backgrounds to identify activities and interests for those who chose not to participate in resident’s meetings. Staff did not always know about people’s personal histories and preferences and were not aware of individual goals they wished to be working towards and how best to support them to achieve their goals. This meant people were not always supported in expressing themselves in a way which reflected their personal histories and cultural backgrounds. Relatives confirmed that. Comments included,“[Staff] try their best, but it is only basic care because there is not anyone organising things” and “[My loved one] can join in with some of the musical events which happen once or twice a month. [They] get frustrated because there is no one to play dominoes or cards with.”

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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.

At our last inspection we found people did not always have equal access to activities and social stimulation and people cared for in their rooms were not always included in the daily activities.

At this inspection we found some improvements were made to include people cared for in their rooms in daily activities however evidence showed people were not always offered meaningful and person-centred activities of their choice. We reviewed records of activities for people and found some people did not have any activities recorded in their daily notes for over 4 to 8 weeks and others had 1 activity recorded per fortnight. People cared for in their bedrooms had very limited choice of activities recorded like listening to music, watching TV or visits from family and friends.

Staff did not always demonstrate a good understanding of which people were most likely to experience inequality in experience or outcomes. They did not fully understand the impact on people who experienced inequality or their role in minimising this. Some steps were taken to minimise barriers to inclusion and positive experiences however they were not always effective in ensuring equality in experience and outcomes for all people and not fully embedded. Relatives expressed their concerns about limited access to activities some people experienced. Comments included, “The lift has been broken on several occasions. [My loved one] goes downstairs quite rarely anyway, so doesn’t often join in with any activities now” and “The residents upstairs don’t get to come downstairs and don’t join in any activities. The lift is old and sometimes out of action.”

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.