Dalkeith

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.

The service was in breach of legal regulation in relation to person centred care.

This service scored 62 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans did not always contain information that was factually correct and made it difficult to identify current and relevant details. In some cases, sections of care plans contained the wrong next of kin information that did not pertain to the individual. This reduced the clarity and accuracy of the records and increased the risk that staff may rely on outdated or incorrect information. In addition, the language used in one care plan was disrespectful. There was a risk the language used would be adopted by care staff within the team, reinforcing negative stereotypes and developing a poor culture where people were not treated in a dignified manner.

Some care records contained limited detail or information that was not sufficiently meaningful to reflect individual needs. For example, one person’s care plan stated staff should support their spiritual needs; however, there was no further guidance to explain how staff should support the person to meet their spiritual or cultural requirements. In another example, a person was known to become distressed when being moved from their bed, but there was no information recorded to describe how staff should manage this to reduce the person’s anxiety. This meant staff, particularly those who were new or unfamiliar with the person, did not have access to the information needed to understand and respond to individual needs if the person was unable to communicate these verbally.

Where care plans were personalised, they provided clear guidance on how people wished to be supported and what mattered to them. However, this was not consistent across all records. The provider recognised the need to improve the structure and accuracy of documentation and confirmed they were reviewing care plans to ensure information was specific, relevant, and reflective of each person’s needs.

Staff knew people well and were able to describe their routines, communication styles, and what was important to them. During observations, staff interacted with people in a way that reflected this understanding, offering choices and adapting support to meet each person’s needs and wishes.

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.

Staff demonstrated they understood the diverse health and care needs of people they were supporting. We saw the service worked in partnership with other services to meet the needs of people receiving care.

We received positive feedback from external professionals. One professional said, “The service is good at communicating people’s healthcare needs with us and they have the residents’ best interests at heart.”

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

People’s communication needs had been assessed and recorded so staff were aware how to support them and ensure any aids required were in good working condition and with the person.

Information was provided in accessible formats and adapted to meet individual needs. For example, Personal Emergency Evacuation Plans (PEEPs) were made available in a pictorial format to support understanding and accessibility.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Complaints were managed in line with the provider’s policy. People felt encouraged and supported when raising issues, and staff were recognised for their compassion and understanding.

The provider had a complaints policy; however, the policy did not have a review date. The absence of clear review timeframes meant there was no assurance the policy would remain current or effective. This limited oversight and increased the risk that complaints would not be managed in line with best practice. Following the assessment the provider and registered manger were reviewing and updating the policy to include the time frames for review.

There were no concerns reported by people and family members we spoke with, and we saw compliments and thank you cards from relatives.

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

Staff ensured people could access the care, support, and treatment they needed in a timely manner. People’s care needs were assessed prior to admission to the service, to ensure any specialised equipment or support was available prior to their admission.

People were able to access the care and support they needed, including input form GPs and other specialist teams. An Equality and Diversity policy was in place to support equity in access for people using the service.

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.

Staff treated people equally and without discrimination. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Care plans included information about people’s goals, aspirations and interests and what was important to them. Staff had received training in equality and diversity.

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.

People’s end of life wishes had not always been adequately explored, recorded or reviewed. Care plans we reviewed did not contain information about what was important to people at the end of their life, including preferred place of care, cultural or religious needs.

Following our assessment the provider confirmed they would be reviewing last wishes and future care planning.