Florence House

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.

This service scored 32 (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.

People were not involved in the writing or review of their care plans. This meant they did not reflect their life history, wishes or preferences.

The quality of the care plans was poor. For example, the plan covering medication did not state what medication people were on, what it was for, any side effects, or how it should be given. For one person who was on covert medication, their plan said it was given covertly but no details of the medication they were on and how it was to be given.

Updates to care records were not being done regularly with some out of date by 4-5 months. Some changes were done to one section without the remaining of the record being changed to reflect this so there were inconsistencies.

Staff told us the care plans were not accurate or up to date. The senior carers were supposed to update the care plans, but they had no training on how to do this which impacted on how well they were written.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities.

Care was not always joined-up, flexible or supportive of choice and continuity. There had been a turnover of staff and managers which had led to a decline and impacted on the knowledge, skills and experience to lead the team and provide support and care.

The provider linked in with health care professionals for regular meetings to help with continuity of care. However, health care professionals told us of their concerns about lack of re-enabling people to gain independence skills and risk of people becoming institutionalised.

Another health care professional told us of how they had worked well with the service to provide a consistent level of support and gone the extra mile for one person with a creative package of support to manage a difficult situation. This was especially true of the senior carers.

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

The provider did not consistently ensure people received information in an accessible format or their communication needs were met. We were told there were no people with specific communication needs. However, one person wore hearing aids as they were deaf. Their care plan did not cover this, but it was identified in a risk assessment plan which stated one of their triggers to becoming aggressive and irritable was not being understood by others. It suggested staff could write down what they were saying to help them understand. However, in reviewing their daily notes for a 2-week period there was only one reference to putting their hearing aids in and no guidance or evidence the batteries were being checked to ensure they worked correctly.

The service user guide was in easy read format.

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

There was no system in place to ensure informal complaints were addressed. We were told there were 5 complaints in February 2025 which were related to food being cold and other people’s behaviour. There was no evidence these had been addressed as similar concerns were raised in a resident’s survey and at resident meetings in February and May of this year.

There were posters advertising advocacy services displayed.

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

Care was not always aligned with best practice or quality standards. The premises was not always accessible and to a good standard for people. Staff did not always provide support to help people overcome barriers to receive support they needed. Care plans did not record when people accessed health and social care professionals and the outcomes from these to ensure their care needs could be tailored to their needs.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

When people raised concerns at meetings and in surveys about such things as food and other people, actions were not taken to resolve these issues. There was a lack of activities and engagement with community services to promote people’s independence and living skills.

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 were not encouraged to have plans for their future, set goals and develop their independence. There were no discussions about end-of-life care and was not an area identified as part of the structure of the care plan system used.