Baylham 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 inspection we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 57 (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.

Care planning and daily care recording was not consistently person‑centred. Records we viewed showed that information was often task‑focused rather than reflective of people’s unique needs, preferences and day‑to‑day experiences. In several care plans, sections intended to capture personalised details contained generic or duplicated wording and did not provide enough insight into what mattered to each person. This meant staff did not always have the guidance they needed to support people in a way that upheld their preferences.

The manager told us they were aware of the shortfalls in the care planning and this formed part of their service improvement plan that they were actively working towards.

We observed good interactions between people and staff; many staff were warm and attentive when they engaged with people. A range of activities were arranged by dedicated staff, and these were well received. A staff member told us, “Activity coordinator is always involving all [people], and I have noticed that they are engaging and it appears that they are happy and participating in all craft activities. Some [people] prefer to have 1-1 activities which is provided as well from the activities team.” Another staff member said, People are asked if they would like to attend and those who are not able to or want to can have alternative activities more suited to their mobility and preferences.”

The staff team demonstrated an understanding of the diverse health and care needs of people living at the service and of the wider local community. The service had established positive working relationships with relevant health and care professionals, who visited the service regularly to provide advice, guidance and specialist input when required. This joined-up approach helped to ensure people received timely and appropriate support. Relatives told us their family members’ needs were being met and confirmed that regular appointments and visits took place, including routine and responsive input from GPs and other healthcare professionals where needed.

Care plans included information about people’s communication needs, individual preferences and the use of communication aids; however, they did not always contain sufficient detail to fully reflect people’s needs.

Many staff communicated clearly and took time to explain information to people. However, information was not readily provided in accessible formats, which limited understanding for some individuals with specific communication needs. After the inspection the provider told us, this was not a need for current service users, but information could be provided in different formats if people requested this.’

Feedback from relatives about communication was mixed. Some relatives told us they were kept informed about changes in their family member’s health, while others felt that communication needed to improve. One relative said, “We always get calls if there are any changes to medications or if [family member] is not well.” Another relative told us, “Unless I ask, I don’t know anything.” The manager was aware of these concerns and was working to improve the accessibility of information, particularly for people living with dementia, as well as communication with relatives.

The provider had systems in place to encourage and support people, and those important to them, to share feedback, raise concerns and contribute ideas about their care, treatment and support.

A complaints process was in place, and information about how to raise concerns was available to people and their relatives. People and relatives told us they knew how to raise issues if they needed to and many felt able to speak to staff or the manager directly. Records showed that concerns were documented and responded to, and the manager described how they reviewed feedback to identify themes and inform improvements.

Regular meetings were being held for people living at the service and their relatives. These meetings provided opportunities to share updates about developments within the service, including staffing, activities and environmental improvements. People and relatives were encouraged to talk about their experiences, suggest ideas and ask questions to the manager. We attended a meeting on the day of our inspection visit and saw there was a wide discussion where all views were actively sought.

The provider did not always ensure that people could access the care, support and treatment they needed when they needed it. Systems to support equitable access were not fully effective, as essential equipment was not always available or in good working order. This reduced some people’s ability to receive timely and appropriate care and created additional challenges for staff in meeting people’s needs safely and consistently.

Equipment required to support people’s health and well-being, including specialist beds, hoists and communication systems, was not consistently accessible or fully functional. Staff told us this affected how quickly and effectively they could respond to people and, at times, limited people’s access to care. One staff member said, “We have a call bell system for the rooms, but we only have one screen on the floor – we really need 2. We also don’t have enough pagers or walkie‑talkies. Some beds are beginning to fail, and we could do with an extra hoist, but that depends on whether the company is willing to purchase them.” During the inspection visit we saw the manager had arranged for bed servicing to be completed, however, this had been delayed from last year.

People’s care records showed that referrals were made and people were supported to access care and treatment when required; however, the inconsistent availability and condition of equipment meant access was not always timely or equitable for everyone.

Staff and leaders did not always consistently recognise or respond to information about people who were more likely to experience inequalities in their care or outcomes. As a result, care was not always sufficiently tailored to meet everyone’s individual needs.

Care plans and risk assessments were in place; however, these were not always fully person centred or reflective of people’s complete care needs. Some records lacked clear, detailed guidance to support staff to respond appropriately, particularly where people had complex needs or lacked capacity. People who spent much of their time in their bedrooms, and those who lacked capacity, did not always experience care that actively promoted their physical well-being, as they had fewer opportunities to engage in activities compared with others.

Staff were observed to be kind, caring and respectful in their interactions, and people and relatives spoke positively about the compassion shown by individual staff members. However, care was at times delivered in a task‑focused way. This reflected the complexity of people’s needs and the competing demands on staff time, which meant staff were often busy and had limited opportunity to provide more personalised engagement.

People and their relatives did not raise concerns about discrimination or unfair treatment, and there was no evidence that people experienced deliberate inequality within the service. However, further work was required to ensure care planning and delivery consistently reflected individual circumstances and supported equitable experiences and outcomes for all people.

People were not always supported to plan for important life changes in a proactive and consistent way. Care records did not routinely demonstrate that meaningful discussions about people’s end of life wishes preferences and priorities had taken place in advance. There was limited assurance that people had been fully involved in planning for the future in a way that reflected what mattered most to them. Where this information was missing, staff may not have had clear guidance to support people’s choices and ensure care was delivered in line with their wishes as their needs changed.

Despite these gaps in documentation, staff demonstrated a clear understanding of how to provide compassionate and dignified care to people approaching the end of their lives. Staff spoke knowledgeably about people and working closely with health professionals to ensure people’s needs were met promptly. They told us they focused on providing reassurance, comfort and emotional support to both people and those important to them at what could be a very distressing time. One staff member told us, “Yes, relatives often stay overnight with their loved one. Often the housekeeping department set up sleeping areas for their families, they can order food, have hot drinks. [People] are monitored, mouth-care provided and are kept comfortable in a dignified way. Kept warm, with music on, photos of their family by their bed and staff talk and reassure the [person].”