West Ridings 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 inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of legal regulation in relation to person centred care and governance at the service.

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 with people, to decide how to respond to any relevant changes in people’s needs.

We found people’s care was not always planned or delivered in a way that met their needs and preferences. We found examples of people who required support from staff to anticipate their needs not being regularly supported to access communal areas or being offered social interaction, which placed them at risk of further social isolation and ill health.

At this assessment, we found a continued lack of evidence of people being supported with frequent showers or baths, and there was no evidence of staff offering them or people declining to have this support. Some people and relatives also raised concerns about this area of people’s care. Their comments included, “There’ve been occasions when I’ve wanted them to give me a shower, and you keep on asking” and “Staff often don't manage to give [person] a shower. I feel that [person] needs more showers.”

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

We found inconsistency in how people’s care plans were implemented in the delivery of care. For example, people who required additional equipment to manage their risk of falls, did not always have this equipment in place.

Some care plans did not have essential details about the care people required, such as the frequency of repositioning, details of sugar level ranges in diabetic care plans or how staff should support people when they were communicating their distress and agitation through their behaviour. This meant, people did not receive consistent and person-centred care by staff.

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

We found inconsistent compliance with the accessible information standard. Some people were given information and choices by staff in a way that was adapted to their needs. But we also found examples when staff were communicating with people living with dementia and they had not adapted their approach to ensure people could understand and make a choice. One person living at the service did not speak English as their first language, and although their communication care plans included methods of how to effectively communicate with them staff were not aware of these or using them.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There was limited evidence that staff had involved people in reviewing their care and many people and relatives told us they had not seen their care plans. Comments included, “I have not seen a care plan, and I don't think I've done anything to support the care plan with this home.”

There was a complaints procedure in place and this was being followed. A relative told us, “I have made complaints about the dehydration, [person’s] teeth and shaving issues. The home has acted on these and things have improved a little.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Following our last assessment, care plans were reviewed however we found this has not always been done in partnership with people and relatives, and it was not always being followed by staff.

People gave us mixed feedback about being able to access the garden areas or go out of the home with staff’s support to do shopping or other activities due to limited staff’s availability.

People told us they had access to health professionals such as GP and district nurses. Referrals were made to health care professionals when required.

Staff and leaders did not always actively listened 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.

We could not be assured people were meeting their outcomes or that these were being effectively monitored because they had not been involved in reviewing their care and we found several examples where care plans were not being implemented.

Although some care records demonstrated consideration to people’s protected characteristics, such as if people required any mobility aids or if their mental health impacted their communication, we found staff did not always follow these.

People were not always equally supported to access activities that were meaningful to them.

There were activities happening at the service and an additional care coordinator had been employed since our last assessment. We observed activities happening in communal areas and there were also activity areas where people could independently access crosswords and puzzles; we did not see people using these. We found there was a lack of activities and meaningful interaction being offered to people who stayed in their bedrooms and for people who lived with dementia. People shared mixed feedback about activities. Their comments included, “I am quite happy as I am I don’t like games like bingo and anything like that” and “We just sit here and talk” and “They [staff] don’t have much time to take you out.”

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’s care plans contained information about their preferences around end-of-life care and whether people had a Do not attempt cardiopulmonary Resuscitation (DNACPR) orders in place or not and where staff could find the original copy in the event of an emergency.

At our last assessment we found concerns about documentation not being in place for people who had been prescribed anticipatory medication to have access to these in a timely way. In our sample of records, we found improvements had been made in this particular area.

However, concerns were raised about some healthcare professionals about palliative care and nursing staff not being confident with administering required medication via a syringe driver. The provider showed evidence that staff had been given additional training in this area and additional training was scheduled.