Yarborough House RCH

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 changed to inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The provider was in breach of legal regulations in relation to person-centred care, staffing and good governance.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not receive appropriate care and support to meet their known needs. Records showed most people were not supported to regularly shower, wash or maintain their oral hygiene. For example, records showed one person was only supported to clean their teeth and dentures on one occasion out of 28 days. This meant the provider could not demonstrate people were receiving the personal and oral care they required or provide assurance that concerns relating to personal hygiene and oral health would be identified and addressed in a timely way.

Care plans had improved since the last assessment, as they contained greater detail about people’s preferences and needs. However, shortfalls remained. For example, one person used a catheter, but there was no risk assessment or care plan to guide staff on how to provide appropriate catheter care.

The provider did not ensure there were sufficient resources to support appropriate care provision and to meet people’s assessed needs. Staffing levels were low and had resulted in care provided not being sufficient. For example, there were delays in staff meeting people’s pressure care needs.

Although staff were supported by a longstanding team of staff, care provision was inconsistent as there was no effective monitoring of care delivery. For example, people who required textured diets received meals and drinks of varying consistencies which were not in line with their care plans.

The provider did not always supply appropriate information in formats that were tailored to individual needs. Care plans recorded how people communicated, however, information was not always presented in formats that supported people to understand and make informed choices. For example, menus were not always updated to reflect the options available or presented with pictures to assist people to make choices. This meant people with cognitive or communication difficulties may struggle to understand what was available. The registered manager told us they were working to improve communication with people with sensory difficulties as they had made referrals to relevant professionals.

Systems were in place to support gathering feedback from people and staff in the form of surveys and meetings. However, the provider did not always ensure changes which affected people’s day to day life were discussed with people. For example, people were not consulted on the proposed summer menu prior to changes being made. This meant options on the menu did not always reflect people’s preferences.

Whilst we identified these shortfalls, people and their relatives told us they could approach the registered manager with any issues and were confident they would be acted upon.

People were not consistently supported to access the care, support and treatment they needed, when they needed it. We found referrals to relevant professionals were not always made for people at risk of malnutrition and action was only taken after we requested assurances that referrals had been made. Records also showed people's personal care and oral health needs were not always met, which reduced assurance that everyone had equal access to the support required to maintain their health, wellbeing and dignity.

People who are most likely to experience inequality in experience or outcomes were not always actively engaged within their care. This meant people’s care was not always tailored in response to this. Although staff were trained in equality and diversity, we found people with greater needs were at increased risk of social isolation and exclusion due to the lack of opportunities for them to socialise and engage with staff, their peers and the local community.

Planning for future care was not always sufficiently detailed or person-centred. Whilst people and relatives had opportunities to discuss future wishes, records did not always evidence these discussions or provide clear guidance for staff on how to meet people's preferences at the end of life. Staff told us they tried to stay with people who were at the end of their lives to offer comfort and companionship, though they told us this was not always possible due to staffing levels.