Croft House Rest 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 54 (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 treatmentand they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.
People’s care plans did not fully reflect their physical, mental, emotional and social needs and there was a lack of information relating to people’s protected characteristics.
Due to a staffing levels and limited options available at the home, we could not be assured people’s needs and preferences were always met. A person told us, “I walk up the stairs for exercise. Staff try their best, but they can’t just drop everything [when I want to go out]”.
However, people and relatives confirmed they were involved in planning and making shared decisions about people’s care and treatment. A relative told us, “Me and my wife had input into the care planning and was heavily involved when [person] came to Croft House Rest Home. We are kept up to date.”
Staff gave examples of person-centred care, and we observed them providing different levels of support to people dependent upon their individual needs.

The provider did not fully understand the diverse health and care needs of older people and those living with dementia.
Managers and staff did not seem to have a good understanding of people living with dementia. Records demonstrated a lack of understanding; and evidenced staff had not responded in the most appropriate way to associated behaviours. For example, terminology used in distressed behaviour monitoring records was inappropriate, referring to people as ‘rude’ and ‘in a bad mood’. Actions included, ‘removing’ people from communal areas.
Some staff lacked training in several topics, to aid their understanding of the needs of older people; including dysphagia, falls prevention, epilepsy and oral hygiene.
However, the rota evidenced a small, consistent staff team and absences were covered by managers or bank staff who knew people well.
Following our feedback, the provider sourced additional training for staff to support their understanding of the needs older people and people living with dementia.

The provider did not always ensure people’s information met data protection requirements.
Personal information was pinned to a communal notice board, and staff were overheard to speak about people’s health and care needs within earshot of others.
However, people’s communication needs were noted in their care plans, and they were provided with clear and transparent information about contracts and charges. People or their relatives were provided with a ‘terms of residence’ when people moved into the home, which clearly identified the provider’s terms and conditions.
Since our feedback, the provider has sourced confidentiality training for staff and managers.

The provider did not always learn from complaints and concerns, or see them as an opportunity for improvement.
The complaints file was not available for us to review during our inspection so we could not be assured complaints had been properly addressed or shared with the team. We noted 1 concern raised by a relative had not been thoroughly recorded or investigated. Please see the ‘Safeguarding’ section of this report for more information.
However, people knew how to give feedback about their experiences of care and could do so in a range of ways. ‘Resident meetings’ were held, and relatives were invited to attend. A staff member explained that menus had been adjusted following feedback at the last meeting. Freepost feedback forms were located in the hallway for ease of access.
People and relatives felt confident that if they complained, they would be taken seriously. A relative told us, “I had not been happy, but now that [the concerns are] out in the open, [managers] have listened and took notice. They communicate better with me now, and I have noticed an improvement.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.
People could expect their care and support to be accessible. Reasonable adjustments had been made to the property and people had access to the necessary equipment. A staff member said, “We have everything we need [to support people]; handling belts, slide sheets, hoists etc.” A partner confirmed managers had requested support when additional equipment was required. The registered manager lived on-site so they could support the team out of hours, or in an emergency.

Managers and staff 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.
People, relatives and staff raised no concerns about discrimination at the home, and staff had access to the provider’s equality and diversity policy.

People were not 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 decisions and what mattered to them were not always delivered through personalised care plans. One person was receiving end-of-life care at the time of our inspection. There was no reference to this in their care plan, and information had not been updated to guide staff around their changing needs or how best to support them. Their advanced wishes had not been recorded, to ensure staff were aware of their preferences and they had control over their end-of-life care.
The deputy manager confirmed appropriate healthcare partners were involved in their care, but visits and agreed actions had not been recorded; or triggered a proper review of their care needs.
The provider did not provide staff with training in end-of-life care to improve their confidence in managing symptom, and providing practical and emotional support to people.
However, the home worked closely with the local hospice and district nursing team when this was required.

Since our feedback, the provider has sourced appropriate training in end-of-life care.