Cloisters Care Home

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

People did not always receive personalised care which met their needs or reflected their preferences. People were not always involved in planning their own care. There were systems to help promote equity of experience and outcomes. However, people's lived experience did not always reflect these.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were able to tell us about the people they cared for, but also explained they did not always have time to meet their needs. They told us they tried to support people with showers and getting dressed.

Staff interactions with people were often task based and time limited. This meant people did not always receive personalised and meaningful care. People appeared well groomed, were wearing clean clothes and had their hair and nails cleaned. People were wearing their own clothes and looked comfortable. People were able to have a choice of food and drink, could join in a range of social activities, and were able to receive visitors when they wanted.

People did not always receive personalised care because their needs had not been assessed or planned for in enough detail. Care plans included basic information. This was sometimes out of date and changes in people's needs had not been recorded. Some people had complex health or nursing needs. Care plans about these needs were not detailed enough and sometimes included vague or inaccurate guidance. This meant that some people did not receive the right support when their needs indicated something was wrong. There was not always enough information for staff to know how people expressed their choices. Although the regular staff knew people well and told us they shared this information informally. Records of care indicated people did not receive regular support with oral care. People using the service and relatives told us they were generally happy with the care they received and this had improved in recent weeks. One relative explained, ''Up until a few weeks ago, I would arrive late morning and find [person] dishevelled and not dressed.''

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The staff spoke positively about people they supported. They expressed how they wanted to provide good care and listen to people. They knew people's individual needs and could anticipate some of their choices and how they wanted to receive care and support.

People did not always have the opportunity to be involved in planning or reviewing their own care. They and their relatives were invited to group meetings with managers. They were informed about key events, activities, the building, staffing changes and food. They were able to express their views on these matters. However, they did not always have opportunities to speak about their own individual care and support. People were given choices at mealtimes. There was a pictorial menu and staff showed them different options. There was also information about some of the planned activities for people to view. However, these were not always updated in a timely manner to enable people to make choices in advance.

People did not always feel they were listened to. Whilst people told us they could speak with individual familiar staff, they did not always know who to speak with if they had concerns which they wanted to escalate or to feedback about their care. Some people and their relatives told us concerns had not always been acted on in a timely manner when they had spoken up. Some people told us they joined in group events, although not everyone could recall attending meetings. One person told us, ''Sometimes there are meetings, they are not regular, but they involve you in the group you are in. They are useful but some people just like to complain.''

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Whilst the provider had policies and procedures regarding equality and diversity. These were not always implemented effectively. People were not involved in planning or reviewing their care plan to make sure their equality needs were met. Care plans did not always give personalised information about people's preferences. For example, there was limited information about how people's religious, culture, or sexuality needs could be met.

Feedback from staff showed that people did not always experience equity in outcomes because they sometimes received care which met the needs of the staff structure, rather than their individual needs. Staff meeting minutes and records of shift plans showed that some people were supported to get washed and dressed by night staff. We discussed this with the deputy manager who acknowledged that this was sometimes a practice adopted by staff to help reduce the amount of work day staff needed to do. The management team agreed this practice was not appropriate and people should only be supported to get up at this time when it was their choice. They agreed to address this with staff.

People did not always experience equity in outcomes. People's individual cultural needs were not always understood or met by staff. For 1 person who did not speak English as a first language, the care plan stated, ''[Person] is talking a lot in [their language] now a days even though staff tell [them] to speak English as we don’t understand.'' The care plan also stated they were unable to express their needs. We heard and witnessed the person expressing their needs clearly in their own language. However, these were not met because staff did not understand them. The staff supported people to celebrate different religious and cultural events. People were able to eat culturally varied meals and listen to music or watch television which reflected their culture. Staff did not rush people who were distracted and disorientated. They were patient, allowing people time to understand what was being said. They offered visual clues and tactile reassurance when needed.

People told us most staff were kind and caring towards people. However, a lack of staff knowledge and skills, as well as a failure to assess and plan people's individual needs meant there was a risk that people would not experience good end of life care which met their needs or reflect their preferences.

We spoke with a health professional who visited the service regularly. They told us that they had observed staff failing to recognise the signs of deterioration when people who were at the end of their lives needed a change in their care. This resulted in a poor outcome for this person. Nursing staff had not had up to date training in some of the areas required for providing good quality end of life care.

People's care plans did not include good end of life care planning. There was limited or no information about how they wished to be cared for and any specific interventions they needed or wished for regarding end of life care and in death.