Rowan Garth 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 requires improvement. At this assessment the rating has remained the same. This meant people’s needs were not always met. The provider was in breach of the legal regulation person centred care.

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 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 were not accurate or fully reflective of their needs.They failed to adequately reflect people’s up to date physical, mental, emotional and social needs. Sufficient reviews of people’s needs and care did not take place to ensure care plans reflected any changes. These shortfalls impacted on the ability of staff to provide person centred care.

There were little evidence people, and their relatives were involved in developing the person’s plan of care in partnership with staff at the home. Information about people’s individual wishes, preferences and routines was limited. People’s preferences were not always respected or enabled. For example, one person’s care plan stated they preferred a bath to a shower, but the person was not able to have a bath, as there was no suitable bath hoist/chair to help them to safely get into and out of the bath.

There was an activities co-ordinator employed by the service and some people confirmed activities took place whereas others told us they spent most of their time sitting in the lounge. The activities some people described included outside entertainers, physical exercises such as yoga, gardening and bingo. People’s care records contained little information about what types of activities or previous hobbies they had enjoyed to enable the provider’s activities programme to be tailored to their preferences.

People’s living with dementia and behaviours of concern did not have personalised plans in place to guide staff on how to minimise their anxiety and distress in a person centre way.

We observed at times staff failed to interact with people in a meaningful way and were task rather than person focused. Some staff also did not recognise when people needed additional support. For example, during lunch one person was unable to reach her plate from her chair. Another person was seen struggling to eat independently and staff needed to be prompted to provide support.

People and relatives had mixed opinions as to whether staff knew them well. Comments included, “Some do, some aren’t interested in what you do or don’t like”; “I think they do” [know me well]; “Generally but hasn’t been here very long yet”’ and “Not really, [Name of person] used to love TV but doesn’t get to watch it here”.

Staff received training in person centred care. People overall felt staff looked after them satisfactorily and spoke positively about the staff team.

There were 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.

People’s needs and care was not properly assessed or planned to enable the provider and staff to understand people’s individual and diverse health and care needs. This impacted on their ability to provide care supportive of choice, continuity and positive outcomes. The provider did not demonstrate they fully understood the mental health needs of people living with dementia or other mental health conditions. Dementia and mental health care planning was poor and the environment in people lived was not dementia friendly in support of their mental health.

Referrals to other health and social care professionals were made in support of some people’s needs. Some people’s care was also discussed at the weekly multidisciplinary meeting with the home’s registered GP, community matron and other professionals. People’s care records were however not always updated with the advice given or action taken following these multi-disciplinary meetings.

Most people and their relatives told us they were able to see their GP when needed. One relative told us, staff had “arranged video appointments at the weekend” when needed.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider had systems in place to keep people’s personal information secure.

People’s care records held information about their communication needs however this information was sometimes unclear. Communication care plans for people who experienced difficulty with communicating verbally did not provide sufficient information about the hand gestures, sounds or facial expressions people may use to express consent, pain or other emotions. Some people care records did not show the provider had tried to support the person to communicate or receive information from the use of communication aids, such as picture cards.

Noticeboards were used to display useful information for example, the activities timetable. However, most of the information provided was in written format and was not always easy to read. For example, the activities timetable was pinned high up on the noticeboard in small font which was difficult to see.

People’s personal information was collected and stored in line with data protection legislation. Staff received training in data protection including the General Data Protection Regulation (GDPR).

The provider had some systems in place to enable people to share feedback and ideas, or raise complaints about their care, treatment and support. People’s records did not always show they were always involved in decisions or reviews about their care.

We were not assured the provider carried out regular care reviews with people living in the home. People’s care plans were reviewed monthly, but review records were brief, did not demonstrate care plans had been properly reviewed or that people were actively involved in the review process. There was little evidence of any other care review process which involved people and/or their relatives. Some decisions about people’s care had also been made without due regard for the Mental Capacity Act 2025.

Resident and relatives meeting took place to seek people’s views on the running of the service and to obtain feedback and suggestions for improvements. For example, records showed discussions about laundry/lost property, activities, menu planning and suggestions for employee of the month.

A survey of people’s views and feedback on the quality of the service and the support received was conducted in 2024. Positive feedback and areas of improvement were identified, with a ‘You said, We did’ report on the action taken following the survey. This was good practice.

There was also an opportunity for visitors to provide feedback on the home via the provider’s electronic visitor management system, which visitors used to log in and out of the home.

There was a system in place to ensure complaints were responded to. The provider’s 2024 survey showed people felt able to raise a complaint or concern and felt it would be handled appropriately. The people we spoke with during our assessment confirmed this. Comments included, “Can talk to any of the staff” and “They have met complaints head on, and they have been dealt with”.

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

Access to the service was not always co-ordinated safely by ensuring the service was able to meet people’s needs on and after admission. People’s needs were also not properly assessed which impacted on the provider’s ability to identify whether people needed access to care, support and treatment from other health and social care professionals.

Referrals to other health and social care professionals for additional support with regards to nutrition, skin integrity and mental and general health had been made for some people.

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.

People’s care was not adequately tailored to their individual needs. People’s care plans included limited information on their personal characteristics, wishes and preferences to ensure care was personalised and provided in the way they wanted. Improvements to enable people living with communication difficulties or dementia to communicate their needs were also required to ensure their experience was equitable.

Equality, diversity and human rights policies were in place to make sure people were treated fairly, regardless of their age, sex, race, disability or religious belief. Staff had completed training in equality and diversity and understood people had a right to be treated fairly and equally.

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.

No one at the time of our assessment was on end of life care. However, some people had DNARs (do not resuscitate orders) in place and some people lived with degenerative health conditions likely to worsen over time. Despite this, there was little evidence discussions around people’s end of life wishes and preferences had been taken place. It is important these discussions take place whilst people are well enough and have the capacity to make decisions about their future care. The care plans in place were generic.

Staff had received training in end of life care.