Romney 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 remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 plans were not personalised, or reflective of person-centred care. This was because there was limited information about people’s preferences or what was important to them.

Information within care planning was not always up to date and reflective of the person’s needs. For example, there was detailed information about the use of a hoist, but this was no longer used, so not appropriate. Another plan stated strategies were being worked on due to a relative raising concerns about their family member’s personal care. However, there were no details to support staff with improving the person’s support.

Information about injuries were not clearly documented. For example, there was a photograph of a wound which had nearly healed, but not when it was first identified. There was no description of the wound including its size or colour, and no treatment plan. This did not enable the wound to be monitored in terms of the healing process.

In the dining room at lunch time, people enjoyed their meal but were kept waiting for their dessert. This was due to staff waiting for the last person to finish. However, this caused agitation and frustration for many and placed pressure on the person still eating. Staff did not recognise this or adjust their practice accordingly. This did not demonstrate personalised care.

People told us they were happy living at the home. Specific comments included, “At times we have a really good laugh, and it feels right for me” and “It’s all very friendly.” Relatives were equally positive. One relative told us, “They’re loads better since they’ve been here”. Another relative said, “In hospital they had to be hoisted. Here they have been very supportive with their exercises and physio. We are relieved they are now walking.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Leaders had worked at the service for many years and knew the local community well. This meant they were knowledgeable about what was available to people, and how services could be accessed.

Records demonstrated people used various services such as the local surgeries, podiatrists, opticians and pharmacies. People confirmed this. Specific comments were “I see the district nurse, and I’ve seen the GP. I’ve seen the dentist and had my eyes tested” and “I’ve seen the district nurse a couple of times for a routine blood pressure check.”

A health and social care professional confirmed their team were regular visitors to the service. They said staff followed any advice they gave and were good at keeping them informed.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff were aware of people’s communication needs and how they adjusted their support. For example, we observed staff explaining the meal content to a person with sight loss, including where different food types were located on their plate. Staff crouched down to some people’s level to gain eye contact and spoke clearly. They used the person’s preferred name to gain attention.

Some people used technology such as a reading machine for books and newspapers. However, one person told us they did not have subtitles on their television, and the light was not ideal to help their sight. They said they would discuss this with staff and leaders.

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

Leaders told us they spoke to people and their relatives daily, and in more detail when they covered a care shift. However, records of these conservations or any changes made as a result were not documented. This did not demonstrate people were listened to or their views were used to shape the service.

Leaders told us formal systems such as resident meetings and surveys had lapsed. This did not give people further opportunities to share their views, particularly if they wished to do this anonymously. Leaders told us they aimed to ensure both systems were undertaken in the next few months.

People told us they would be happy to raise a concern with staff or leaders. Specific comments included, “I’m confident that [names of managers] would put things right if anything needed to be done” and “If you have a problem, you only have to bring it to their attention and they rectify it.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People were supported to access healthcare services and gain any equipment they needed. One relative told us their family member used to use a walking frame, but staff had identified their needs were changing. A wheelchair was therefore encouraged at times of tiredness, to enhance safety. Another relative told us, “[Family member] is being assessed for a new wheelchair because the old one is no good outside.”

People told us staff arranged transport to enable them to get to hospital appointments as needed. A relative told us, “Any clinic checks, they have contacted me and have organised transport. A family member will usually go with him, but they would send a member of staff if we couldn’t go.” Leaders told us home visits would be arranged, if possible, for those people who had difficulty travelling due to frailty.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Leaders were aware of potential inequalities and promoted people’s rights. They said they strived to ensure a family environment, where people could feel at home and follow their own preferred routines. Leaders told us they worked with others to minimise the risk of any barriers or discrimination.

People were supported to go in to the local community for leisure such as church. People told us church services were also held in the home or relayed via technology. This enabled people’s preferences to be respected.

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.

Care plans generally stated people did not want to discuss this area of their lives. However, further attempts to engage people had not been considered or instigated. This did not ensure staff had the required information to adhere to the person’s individual preferences, as their health deteriorated. Leaders confirmed end of life was an area people found difficult to talk about, but they would consider how this could be improved.

Records demonstrated if the person wished to be resuscitated in the event of a cardiac arrest or admitted to hospital as their health deteriorated.