Applegarth 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 service met people’s needs.

At our last inspection we rated this key question good. At this assessment, this key question has changed to requires improvement. This meant people’s needs were not always met.

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 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.

We identified concerns with medicines management, and daily monitoring records including those related to food, fluids, and repositioning which were not always completed fully. Some care plans required further review, including due to illegible writing.

Feedback regarding involvement in care planning was mixed, some people and relatives felt included, while others felt excluded from the process. This inconsistency affected how well care was tailored to individual preferences and needs. However, people told us that staff were obliging and responsive to their preferences, including when they changed their minds or requested care to be delivered in a specific way, such as by a female staff member. One relative commented, “[Person] has a better attitude and is much calmer now.”

In addition, the standard of the premises and cleanliness did not reflect person-centred care. Several rooms lacked appropriate window coverings, which compromised people’s privacy, and not all areas of the home were clean or well maintained.

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 consistently recorded instances where individuals experienced skin breakdown or required additional support, which appropriately triggered referrals to external healthcare professionals, including tissue viability specialists. This process was generally effective in ensuring timely intervention and care.

Staff were unable to take wound photographs without the registered manager’s consent, which limited effective monitoring. We discussed about delegating this authority to qualified nursing staff in line with best practice.

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

Information was made available in a range of accessible formats tailored to individual needs, supporting clear and inclusive communication. Communication plans were in place, and care staff demonstrated a good understanding of each person’s communication preferences and requirements. During our visit, we observed staff actively enabling people to express themselves fully, fostering a respectful and empowering environment where individuals felt heard and understood.

The provider had not always made it easy for people to share feedback and ideas. They did not always involve individuals in decisions or changes related to the service. Feedback regarding involvement in care planning was mixed, with some people and relatives feeling included, while others felt excluded from the process.

Additionally, it was noted that surveys had not consistently been completed with people, relatives, or other healthcare professionals, limiting opportunities for broader input. While the management team operated an open-door policy for visitors, feedback suggested this approach needed to be extended and made more inclusive to ensure all voices were heard.

The provider made sure that people could access the care, support, and treatment they needed when they needed it. Staff were available to support people whenever needed, contributing to a sense of safety and reassurance for those receiving care.

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.

Staff had completed equality and diversity training and used this learning to help support people appropriately.

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 were able to discuss their future care wishes, which were documented in individual care plans. This supported a person-centred approach and helped ensure that care aligned with people’s preferences and needs.