Glebe 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 requires improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulation to 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 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 toany relevant changes in people’s needs.

We found people’s care plans lacked consistent and specific information about their needs placing them at risk of not receiving person centred care. Whilst care plans contained varying degrees of information about people, they were not always sufficiently personalised or detailed. Care plans did not have information about people's history and information from pre-admission assessments was not always recorded within the plans. Therefore, care plans did not provide staff with all the information to enable them to meet people’s needs.

We also noted that a person’s information was copied from another person’s care plan. This placed people at risk of not receiving personalised care at all times.

We did not see any evidence on how staff worked with people to review their care plans and there was no information in place to demonstrate how people attended meetings with staff to review their care plans.This meant people did not receive care and support that was personalised to the individual, which was a potential risk that people were not receiving the right care and support. As mentioned previously, care plans had not been reviewed since 2023.

During our recent inspection, we raised our concerns with the management about the accessibility of up-to-date information for staff. Following our visit, we were later provided evidence from provider that the updated version of the relevant information was stored on the service's computer system. However, it was also noted that the setup in place at the time of our inspection did not allow staff to access this system. As staff confirmed this.

This lack of access meant that staff were unable to refer to the most current information, potentially placing people and staff at risk. It is essential that all staff members can access up-to-date guidance and procedures to ensure the safety and well-being of all concerned.

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

The provider worked with other health services, which included people’s GP, district nurses, occupational therapists, and speech and language therapists. However, we noted care records were not always updated after health appointments, in regard to when people's needs had changed, which was not reflected in their care plans or risk assessment. For example following an assessment from a person receiving a dementia assessment.

People had access to a number of health care services within the community. Staff monitored people's health and welfare and reported any concerns to the management team who made referrals to health care professionals where required. However, referrals were not always made in a timely manner. For example, we saw that one person’s assisted technology assessment should have been arranged sooner than it was. This meant people were at risk of not receiving the care and support they needed.

Following our assessment, the provider submitted evidence of updated information relating to referrals for people that us the service. However, during our inspection, staff told the inspector that they did not have access to the relevant documentation. This resulted in a potential risk to people using the service.

The provider did not always 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.

We found people were not always at the centre of their care and treatment choices and were not involved in decision making regarding their care needs. A person told us that they did not feel listened to by staff and at times did not feel involved around making decisions. They said, “I don’t feel that some staff understand the points that I’m making at times. I just feel I’m ignored at times.”

We saw that the service had a system in place to address complaints. At the time of our visit, there were no open complaints. A relative told us they had raised a complaint in the past, which was dealt with appropriately.

During our visit, we raised our concern with the Management team, who assured us that they would review the matter and take appropriate action. Since our inspection, the provider has submitted evidence demonstrating how they have involved people by listening to their feedback and outlining the development of tools to support this approach.

The provider did not always 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.

We found people were not always at the centre of their care and treatment choices and were not involved in decision making regarding their care needs. A person told us that they did not feel listened to by staff and at times did not feel involved around making decisions. They said, “I don’t feel that some staff understand the points that I’m making at times. I just feel I’m ignored at times.”

We saw that the service had a system in place to address complaints. At the time of our visit, there were no open complaints. A relative told us they had raised a complaint in the past, which was dealt with appropriately.

During our visit, we raised our concern with the Management team, who assured us that they would review the matter and take appropriate action. Since our inspection, the provider has submitted evidence demonstrating how they have involved people by listening to their feedback and outlining the development of tools to support this approach.

The provider supported people to access the care, support and treatment when they needed this support.

We saw that people were supported by staff to access a range of different services depending upon their needs.

The registered manager was able to request health services to visit people at home if they were not able to go out. This included peoples GP, occupational health and speech and language.

Staff told us they understood people’s right to equity in accessing care and support.

Relatives we spoke to were confident that the service would arrange for support where this was requested to help ensure that peoples protected characteristics was considered.

Staff and 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.

Due to the issues we identified with the providers systems, we could not be assured that people were achieving their outcomes or that these were being effectively monitored.

Records did not always demonstrate how people, and their representatives where appropriate, were involved in the development and review of their care plans. There was not always clear evidence that individuals were consulted and listened to regarding their experiences, to ensure care plans were personalised and reflective of their needs and preferences.

People with protected characteristics or complex health conditions, such as dementia, did not always have their needs actively promoted or appropriately documented within care records. We discussed this with the registered manager, who informed us that they would be reviewing people’s care plans to ensure they reflect individuals’ experiences, strengths, and personal outcomes.

During the recent assessment, it was identified that the updated information maintained on the office computer was not accessible during the initial two days. And the updated paper records were printed in people’s folder until the third day of our visit. This situation could have resulted in a potential risk, as staff members may not have had access to the most current information when making decisions or providing care during this period.

People were not always supported to plan for important life changes to make informed decisions about their future.

Care plans did not evidence people's wishes for planning for the future. This included information where people wanted to live in the future and things that people want to achieve. Reviews were not being held regularly, and we did not see goals being set to ensure people’s future were explored and action taken to ensure future goals were met.

We saw that people had end of life plans in place with detail about their wishes around the support they wanted. Which had been developed further after our inspection.

We saw that people had end of life plans in place with detailed information about their wishes around the support they wanted. However, during our visit we saw that plans had not been reviewed or updated. The registered manager informed us that they were in the process of reviewing this.

After conducting our assessment, we received evidence indicating that the required information was present on the computer system. However, during our two-day visit to the services, we were unable to access and review this updated information due to access and technical issues. As a result, the information available in the people's paper files did not reflect the latest vision or updates that had been made electronically.