Crowley Care Homes Ltd - St Annes Care Home Also known as St Annes 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

We identified 1 breach of the legal regulations. Care plans were not person centred and staff did not have enough guidance to ensure people were supported in line with their preferences. We received mixed feedback about the social stimulation and activity that was available to people. The environment was not designed in a person-centred way. In the main people’s relatives told us they had been involved in planning people’s care. Processes in place did not ensure people were supported to plan their future care while they had the capacity to do so. The provider ensured people had access to information in formats they could understand. Processes to manage complaints were not fully implemented. The provider worked with local stakeholders to ensure continuity of care for people.

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.

As care plans did not contain detailed information about people’s individual preferences, we could not be assured people received person centred care. People’s care plans had not consistently been completed to inform staff of their cultural, religious needs or personal care preferences. For example, one person’s care plan stated they preferred a particular diet to meet their cultural needs. However, no information was provided about the food and drink they preferred other than porridge. One person’s care plan stated they required two staff to support with personal care, no other information was provided. Another person’s care plan described how they had been neglecting their personal care needs and had been reluctant to accept support prior to being admitted to the care home. The care plan contained no individualised information to advise staff how to support the person in a person-centred way. We received mixed feedback about the social stimulation and activity that was available to people. Some people’s relatives told us there was enough to do and their family members enjoyed the group activities such as exercises, bingo and musical entertainment. Other people said the group activities could be improved by being held at different times of the day. Some people described staff facilitating individual activities, one person described how staff printed off games for them to play.

Staff were able to explain the importance of person-centred care, one member of staff described it as, “Care for the individual resident according to their needs. Each resident has different needs, and you accommodate for them individually.” However, they did not always put this knowledge into practice to ensure people’s preferences were met.

The environment was not designed in a person-centred way. The home provided support to people living with dementia. However, the environment had not been designed to support people to orientate and find their way around the service. People’s bedroom doors were numbered and had a sign stating ‘bedroom’ and an image of a bed. However very few doors were personalised to support people to find their own bedroom. This had been raised as a concern at the previous inspection. We observed activities taking place during the inspection. However, some of the activities were not suited to the needs and preferences of the people living in the home. For example, we saw a quiz taking place in the lounge, but most people did not engage as the questions were not appropriate to their knowledge and understanding.

In the main people’s relatives told us they had been involved in planning people’s care. One person’s relative said, “I think we are in control of planning mums care and support, if I were to request something, I would anticipate the carers would implement the request.”

The registered manager described how people, or their representative were involved in planning their care and this involved discussions about their personal preferences.

The provider worked with local stakeholders to ensure continuity of care for people.

People’s care plans were created with their involvement. However, they lacked the consistency and detail required to ensure people received appropriate support. People’s care records described involvement from community health services such as the primary care network, mental health team and dieticians. However, people’s care notes were not detailed enough to provide assurance the instructions of multidisciplinary professionals were always implemented.

The provider used an electronic care planning system. Some people and their relatives told us they did not know how to access their care records.

Staff described several different formats used to provide information to people in a way that met their communication needs. For example, newsletters being provided in people’s preferred language.

People’s care plans did not always contain accurate information about their communication needs. For example, one person’s care plan described how living with advanced dementia affected their ability to understand verbal communication. However, their accessible information assessment stated they had no special communication requirements. In addition, the communication section of their care plan was blank and information on sight and hearing was inconsistent across different areas of the care plan. There was a risk staff would not understand how to communicate effectively with people. The provider ensured people had access to information in formats they could understand. Documentation was available in easy read formats and people’s preferred language, for example information on safeguarding people from abuse.

People and their relatives told us they knew how to make a complaint. However, we received mixed feedback about the provider’s response to complaints.

Staff were aware of the different ways people’s feedback was collected and described regular surveys taking place. They told us the management team acted on people’s feedback.

Processes to manage complaints were not fully implemented. Although the management team responded to individual complaints, it was not clear from records how these were analysed to enable themes and trends to be identified and lessons learned to be shared with staff.

People’s relatives told us they were supported to access multidisciplinary services promptly when needed. One person’s relative described how their loved one was at risk due to a health condition. Staff monitored the person and ensured they received prompt treatment when acutely unwell.

Staff told us they supported people to access health care appointments when needed.

The provider worked with local stakeholders to ensure people were able to access the services they required.

Processes were in place to ensure people were supported to access the services they required promptly when needed.

People told us that although processes were in place to gather feedback, this was not always acted upon. For example, feedback provided during residents’ meetings did not always result in change. However, people did feel individual staff listened to them on a one-to-one basis and acted on what they said.

Staff were aware of the importance of listening to people. They knew how to obtain information about people’s preferences and needs. One member of staff said, “We get to find out about people's likes and dislikes during handover, by reading the care plans, talking to people and asking them as they might change their mind.”

Processes were in place to enable people to provide feedback on their care. However, these were not always implemented effectively. For example, the ‘Resident Questionnaire’ lacked detail and there was no systematic analysis of the answers provided. There was also no evidence action was taken to support people who could not respond to a written format.

People told us brief discussions had taken place about their wishes for the end of their life and the information had been added to their care plans.

We received mixed feedback from staff about the plans in place to ensure people received care as they wished at the end of their life. Some staff were not aware whether people had end of life care plans in place. Although staff were aware of how to access records of any ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions that may be in place.

Processes in place did not ensure people were supported to make informed choices about their care and plan their future care while they had the capacity to do so. Two people did not have end of life assessments or care plans in place. The provider was not following best practice guidance regarding end of life care. However, one person who had been identified as approaching the end of their life had a detailed assessment and care plan in place. This had been completed with their representatives as they were unable to participate.