Archived: 1 & 2 Flax Cottages

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 good. At this inspection the rating has changed to requires improvement.

This meant people’s needs were not always met. The provider was in breach of legal regulation 9 (person-centred care).

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Care was not always personalised to people’s individual needs and preferences. People’s care plans did not always fully reflect their needs. Experienced staff did well to anticipate when people needed additional support, but the provider’s care plans were not effective at the time of inspection.

For instance, for people who may experience anxieties during aspects of care, or during particular interactions, this was not set out clearly in care planning and risk assessments to ensure staff were guided towards calming, de-escalation strategies.

The environment did not always contribute to person-centred care, with the two bungalows mainly being used as one larger property. There had been some recent group activities, but individualised activity plans and goals lacked detail and recognition of what it was that made people individual. They were at times focussed on the limitations people faced, rather than the experiences they wanted to have and the opportunities they might be helped to explore.

This was recognised in some of the conversations we had with relatives. One said, “They went to the circus at Cramlington recently. They used to have a bus at one time and when they got rid of that people weren’t getting out but hopefully that is going to change now.” Another said, “He really needs more social interactions and we are hoping to improve the social side of things for him. I think they all went to the cinema together recently.” Another said, “I think they need more interests.”

The acting manager had started to review people’s plans at the time of inspection and was responsive to our feedback about the need for these to be detailed and fully individual to the person’s goals, wants and aspirations.

People received consistent care from staff who knew them well and had proved reliable over a period of time. Staff listened to and followed advice from external professionals. Staff had built up good levels of trust and understanding with people.

People received care and treatment from services that understood their diverse health and social care needs, because staff were strong advocates for people and communicated well with external professionals. People’s care and treatment met their assessed needs. At times records needed improvement.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People and families raised no concerns about having access to the information they needed, when they needed it. The acting manager had been proactive in trying to restart ‘family and resident forums’ to involve people more in decision making and the future of the service. Some people were supported with their communication needs by the use of cards or non-verbal gestures, and staff understood these well. This information needed to be better reflected in care planning.

The acting manager and area manager were working hard to rebuild trust with relatives, after a difficult 18 months in which families had not always been listened to. One relative told us, “In the past 4 to 5 months more communication over the phone had increased and improved. For the previous year and a half there was nothing and it was not very pleasant.” Another said, “Standards dropped and we didn’t feel welcome, but it does feel different under new leadership now.”

People felt confident they could complain if they had any concerns. Relatives felt they could raise concerns with the new leadership at the service.

The acting manager has sought feedback on activities, such as VE Day celebrations and outings options. They had conducted reviews with everyone and their relatives to ensure care records could be improved and had a consistent starting point. Relatives welcomed this.

People were supported by staff who understood their needs well. Staff escalated health matters and sought advice regularly. People received the additional health support they needed from a range of external clinicians.

Where people needed increased communication support, the provider needed to do more to ensure their voices were heard, understood, and played an equally important role in shaping the service. Where people had capacity and a clear voice, they were able to comprehensively engage with the acting manager, area manager, and contribute their ideas.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future. People’s care plans included some information about what kind of care and support they wanted for when they neared the end of their lives. This needed review and further person-centred involvement to ensure it was detailed, and gave people’s support networks, including staff, the most relevant information. The distinction between what was needed in emergency healthcare planning, advanced care planning, and end of life care planning, needed to be clearer.The provider had liaised well with people and relatives about prospective changes to the model of care provided at the service.