Camelot Care Homes Ltd

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• 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

We reviewed 7 quality statements in this key question. Improvements had been made to help staff deliver person centred care. This included changes to the structure of the staff team and additional training. People’s communication needs were identified in care planning and formats had been developed in a user-friendly way to aid understanding. Staff worked well with other professionals and kept relatives informed of anything they needed to know. People knew how to raise a concern and were encouraged to give their views about the service.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback about person centred care was generally positive. However, 2 people said they would like a shower more often and on different days than those allocated to them. In response to this, leaders told us people were always given the choice of when and how often they showered, but there had to be some routine in the home. They said it would not be workable for everyone to want their shower at the same time, on the same day. People told us social activities were related to their interests and celebrations had been organised for special occasions. One relative told us their family member enjoyed their day in bed just to rest, which staff enabled.

Leaders told us they had done a lot of research into person centred care. They said as a result of this, discussions had been held with staff about getting to know people better. Leaders told us this had worked well, and people had become more settled and content. Staff understood what person-centred care meant, and said they were able to provide this. They spoke of individuality and keeping people at the centre of everything they did. Staff recognised everyone was different and had different needs and wishes.

Improvements had been made to supporting people with distressed behaviour. People were calm, and staff minimised potential triggers to any distress. This included ensuring one person spent their time in the dining room or entrance area, away from loud noise and crowded space, which they found difficult. However, one staff missed an opportunity to provide individualised care. This involved telling a person to put their placement down, without listening to their reason for holding it. The person’s answer indicated a previous interest or occupation, but this was not acknowledged. People enjoyed the social activities taking place such as clay modelling. This promoted discussion about what they had made, and reminiscence followed. People had been supported to personalise their room, based on their personal preferences.

People and their relatives told us staff liaised with other professionals when required. This included the GP and specialised nurses.

Leaders told us they worked alongside a wide range of professionals to enhance the support people received. This included gaining immediate safety advice from a physiotherapist, prior to them meeting and assessing the person. A GP visited the home each week, which enabled continuity and regular review of people’s health. Staff told us the home also worked well with local businesses. This improved links to the community and helped with community activities.

Health and social care professionals told us they worked well with the service. They said there were some consistent staff which ensured continuity and staff had helped their customer to access the community, which had worked well.

There were systems to ensure people’s support was regularly reviewed. This included input from health and social care professionals as required. A new format had been developed to help professionals provide feedback about the service.

Relatives told us communication was good and they were kept fully informed of their family member’s well-being. One relative told us staff did a small presentation to inform their family member of the complaint procedure and their right to complain. Relatives said they were asked to share their views about the service using feedback forms. They said leaders listened, were open and transparent, and acted on any suggestions they made.

Leaders told us they and the team had worked hard at providing information in a format that people would find easier to understand. This included a visual safeguarding poster and picture cards which showed familiar items such as a drink and medicines. They said whilst they had shown people the information, its full implementation had not taken place. Staff told us they always verbally reminded people of anything that was going on in the home. They said this proved more helpful and better suited to people’s needs.

Information was not always provided in a way that met people’s needs. For example, people were verbally asked in the morning what they wanted for their lunch. This did not ensure people had an informed choice or would remember what they had ordered when it came to their meal. The volume of the televisions was loud, in both lounges all day. This made it difficult to hear what was being said, as well as causing distractions whilst people were eating. Focus had been given to developing processes such as the complaints procedure, in a more user-friendly format for people to understand. However, the weekly activities programme was written in small black text so had not been amended.

People and their relatives told us they were able to give their views about the service. This was through general discussions, meetings, and feedback forms. However, people gave us mixed feedback about their views being listened to. One person told us the meetings were productive, but whilst some things got done, others took longer or did not happen. One relative told us they had been part of a conference call, and minutes of the meeting were taken.

Leaders told us systems had been developed to enable people to be involved in the management of the home. This had included newly formed committees to discuss menu planning and social activity. One person had joined the interview panel to recruit new staff. Leaders told us the person had written their own questions, which had worked well. Due to this, further involvement of people was planned.

Leaders had improved the systems for managing any concerns or complaints. This included better organisation so that all correspondence, including the investigation and how the concern was resolved, were clearly demonstrated. Any action required was added to the home’s overall action plan. There was a complaint procedure, a speaking up policy and feedback forms, which encouraged people to give their views about the service.

People and their relatives told us the environment and the garden were accessible. A passenger lift gave easy access to the first floor. People said they had access to a range of services to meet their health and care needs. This included out of hours GP services as required.

Leaders told us they had found a dentist who would visit people at the home. This reduced inequality as those people who were unable to go to out, could now receive dental care. Leaders told us this service had been really helpful and resulted in treatment plans for some. Leaders and staff told us other professionals regularly visited. This included GPs, chiropodists, hairdressers and advocates. Other professionals such as occupational therapists, physiotherapists and specialist nurses could be contacted when needed.

Health and social care providers told us the service was alert to discrimination and the barriers people may face.

There were systems to ensure people received the healthcare they required. This was particularly important for this who were not able to go out to access external services.

People and their relatives did not raise any concerns about inequality or discrimination.

Leaders told us they promoted people’s characteristics and gave examples of people who had lived at the home with various cultural needs. They said in the past, staff had used their native language to successfully communicate with people, and menus had been devised in a different language. They said people were supported to maintain their faith and attend church, with a video link if needed. Staff told us they ensured they spent time with people who wished to remain in their own room, as well as those in communal areas. This helped to minimise the risk of social isolation. Staff told us cultural differences were accepted at the home.

Communication needs formed part of the person’s care plan. Some of the information was very detailed, which ensured staff were aware of the best ways to communicate with each person. However, staff did not always follow the plans in practice and not all staff had good English language skills. Staff were aware of the risks of isolation and spent time with people. This included ancillary staff who said they spent time chatting to people whilst working in their rooms. There was an equality and diversity policy and staff received training in this area.

One relative told us discussions about their family member’s future health had been discussed with them. This was to ensure their wishes were adhered to at all times. They said a cardiopulmonary resuscitation order had been agreed and staff were aware of this. Other people had similar orders in place.

Leaders told us they were able to provide end of life care, that was dependent on what they or their family wanted. They said some people had chosen not to be resuscitated, and processes had been followed to formalise this. Leaders told us they worked with other professionals when a person was nearing the end of their life. This included sourcing ‘just in case’ medicines, to immediately minimise any pain or anxiety the person might display. Staff told us they received training in end-of-life care.

There was a philosophy of enabling people to have a dignified death at the home, surrounded by people they knew. Other professionals provided support to achieve this as needed. Staff received training, and leaders had a policy for end of life care.