Trafalgar 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

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. This meant people’s needs were not always met.

This service scored 61 (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 always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. The registered manager told us people and those closest to them were involved in regular reviews about their care, however, care records did not demonstrate how they were involved. Relatives told us, “I can’t remember the last time I saw a care plan, there are no regular reviews.” On the day of our inspection, we observed that people did not always look well kempt, and toothbrushes looked dry. We spoke to people who told us, “I like to be clean shaven, but the staff don’t always have time” and, “they do clean them if I remember to ask.” Healthcare professional’s said, “I feel that some of the basic care and hygiene needs are not always met sufficiently.” Whilst is it understood some people may decline assistance with all their personal care, the care plans we reviewed showed staff had not always been given instructions to provide personal care such as assisting people to shave. Care plans did not tell staff what they should do if a person declined support and staff had not recorded in daily notes the actions they had taken to ensure the person understood the decision they were making. This meant not every reasonably practicable action had been taken to support people and they had been placed at risk of neglect.

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 had ensured people could access doctors, district nurses and speech and language therapy when they needed it. People were cared for by staff who knew them well.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff understood people’s communication methods and styles. The provider was following the Accessible Information Standard (AIS). Information was available in a variety of formats and where English was not someone’s first language, alternative language translations were available.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People knew told us they could raise their concerns to staff if they needed to do so, one person said, “If I did want anything I could speak to them, but I have no complaints, they’re so good to me, I get on great with the staff.” Relatives told us that whilst they were no included in reviews, they felt they could always speak with the management team who had an open-door policy. Relatives told us they knew they could speak with staff if they had any concerns. When a relative had raised a complaint, they told us the registered manager had dealt with the concern in a timely manner and they were satisfied with the outcome.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The home was accessible for those with mobility difficulties and bedrooms allowed access for equipment that people may need. Staff accessed healthcare support when people needed it.

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. People did not always have equal access to activities and social stimulation. People cared for in their rooms were not always included in the daily activities. We received feedback from staff who told us, “When activities are on it’s only the same few residents who take part.” We reviewed care plans which clearly detailed how a person cared for in their room was “at risk of social isolation” and, “Staff should ensure that they encourage [person] to come out of their room and spend time in the communal areas with other residents.” However, the daily records we reviewed did not show how staff had encouraged the person to do this and there were no recorded activities or social stimulation. A relative said, “[loved one] does not come out much now. Staff treat [loved one] very well, but I do wonder if they are a bit lonely.”

People were 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. Staff worked closely with visiting healthcare professionals to complete advance care plans with people ensuring people’s choices for any further care and treatment needs were documented.