Wood Hill Grange

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. This is the first assessment of responsive for this service under the new provider. This key question has been rated requires improvement. This meant people’s needs were not always met.

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 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. People did not receive care that was person-centred. We observed staff were task orientated in their approach to delivering care and support. Staff did not engage with people, did not ask their choice, or support them to make decisions. For example, at mealtimes food was placed in front of people, with no interaction, support, or engagement. One person’s food was very hot, and they were told to wait when it was placed in front of them. However, the person did not understand and kept trying to eat the food, we observed they were in obvious discomfort as the food was too hot. Another person’s food required cutting up and they were struggling to eat it, the staff member said, ‘Are you playing with your food or eating it’, they did not ask if they wanted support. The task orientated approach to serving food put people at potential risk of harm.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. The manager had identified that staff did not work joined up with visiting health care professionals. The manager was working with staff to ensure care provision was integrated to provide continuity of care that met people’s needs.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For example, we observed mealtimes and found no menus available or picture cards to assist people in making choices. The manager was aware and had identified improvements were required. They had arranged a meeting for relatives, but bad weather had meant it was cancelled, this had been rearranged. They said, they were seeking people’s view to better improve provision of information.

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 always involve people in decisions about their care or tell them what had changed as a result. Care plans were not up to date and did not always reflect people’s current needs. People did not feel involved in their care delivery. People told us staff did not take time to listen to them, did not support them to make decisions or respect their choices. One person told us how they had raised a concern with staff and the issue was still occurring. They said, “I have told staff that people regularly come into my room (other residents) they come in and out at different times of the day and night the staff have asked them not to, but they still come in, they [staff] are doing nothing about this.”

Relatives told us they had not attended any meetings and said communication could be better. They did acknowledge there was a new manager and were aware of a newsletter and the plans to improve communication. The manager explained they had commenced a monthly newsletter and were also organising a residents and relatives meeting.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. The management team had identified with the local authority contracts team that the care plans required reviewing, updating, and monitoring to ensure peoples current up to date needs were reflected. As part of the reviews the management team were ensuring any required referrals to specialists were made so people were accessing the support they required.

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. People’s social, mental wellbeing and recreational needs were not being met. There were limited or no activities relevant for people. People felt isolated and bored. Many people stayed in their rooms, some said this was because there was nothing else to do. One person said, “I have my nails done, but there is nothing else.” We observed staff sat with people in communal areas, but there was no interaction or engagement from staff. There was one activity coordinator, they worked 5 days a week which included weekends, however, said this was not enough for the number of residents. There were also no activities taking place outside the service. There was an external entertainer who visited once a month, we observed this, it was on one unit, staff were struggling to get residents down from other floors. The management team acknowledged the activities could be improved and more activity hours were required.

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 did not always detail people’s decisions and choices. This meant they may not be supported in line with their wishes. The manager was aware care plans required improving and this had commenced at the time of our inspection.