Rastrick Hall and Grange

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. We looked at the following quality statements: treating people as individuals, independence choice and control and responding to people’s immediate needs. People and their relatives were not always entirely involved in assessing and reviewing their needs, and people’s assessments did not consider the full range of their diverse needs. We observed mixed practice regarding the responsiveness of staff. For example, staff were not always vigilant, or able to respond in a timely way, to people’s needs. However, most staff appeared to know people well and were kind and respectful in their approach.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

Work was underway to make sure people, and their relatives had more involvement in planning their care and support. Some relatives felt staff knew their family member well but felt this was not always the case with agency staff. A relative commented, “New faces come and go, [my relative] doesn’t get used to them.” People’s family and friends were welcome to visit as they wished although there had been some confusion about visiting at mealtimes, when a ‘protected mealtime’ initiative had been introduced.

Staff told us that developing relationships with people allowed them to understand their personal needs and preferences. Comments from staff included, “Most of [the residents] can tell you what they need so it’s about having a conversation with them, making sure you understand what they want and how they prefer you to help them” and; “You need to know the residents, so that you know what that facial expression means, what they do with their hands, if that means yes or no, if they’re happy.”

Most staff appeared to know people well and were kind and respectful in their approach. However, when we asked them about what it said in care plans about people’s choices and preferences, staff were not able to tell us this.

Care plans needed further development to demonstrate a person-centred approach to care. Some life story work had been completed with people, but this was not consistent and details about people’s personalities, experiences, religious needs and aspirations were not always detailed in care plans.

We received mixed feedback from people and their relatives about the activity provision at the service. For example, comments included, “There’s not much to do here. I watch TV”, “There’s supposed to be a snooker table somewhere, I’ve not seen it”, “There are activities happening upstairs apparently, they have not taken [my relative] up in spite of being asked” and “[My relative] is not keen to join in, they like snooker, they’d do that.” We also spoke with a person in their room who had their television on. They told us they did not enjoy the programme that was on, but they did not have access to a remote control to change the channel. A new television was obtained for this person during the assessment, but this appeared to be a problem for other people also. For example, staff had turned the television on in another person’s room but there was no sound, again the person had no ability to change this.

The manager told us they were looking at ways in which people could be more involved in community activities. Staff confirmed this saying, “There are more activities for people now, they go out to church, recently some of our residents went to the local school to meet the children.”

We saw a member of care staff reading a children’s book with two people, who were showing no interest. When we asked about the appropriateness of this, the staff member found magazines to look at instead. The people immediately became engaged, and the member of staff responded to this making the experience very enjoyable for both people. We saw some other people being supported by a member of the domestic team to help with small tasks. The engagement and inclusivity shown by the member of staff was very positive. We also saw staff playing a game with people and then encouraging other people to join, which resulted in the people engaging with each other. However, this level of positive engagement was not consistent across the units, and we saw several examples of staff not taking the opportunity to engage with people.

A resident of the day programme was in place, but this was not being used effectively to check with people about their choices relating to their care and support and to establish their lifestyle preferences. Activity provision had increased and was available over 6 days, although this was not consistent across all units. Records of activities undertaken on the electronic care record system were also poor and included many misleading and inaccurate entries. For example, two people had only one activity recorded in a 28-day period one of which was watching TV in their room and the other was listening to music.

We received mixed feedback from people and their relatives about the responsiveness of staff. Comments included, “Some staff are caring; but most are poor”, “The staff are approachable and friendly” and “The staff are alright, no complaints. They are helpful.”

The manager completed a monthly dignity audit which included observations about aspects of people’s personal care. However, we saw inconsistencies in staff’s attention to personal care across the units. Staff told us they supported people as their needs depended, although some did appear to be guided more by notifications from the electronic care plans. A staff member said, “The device prompts you what to do, so if someone needs checks every 2 hours or 30 minutes it will flag up when a check needs doing again.” Staff did however appear to understand the importance of providing support when it was needed.

Staff were not always vigilant, or able to respond in a timely way, to people’s needs. For example, on two occasions we brought staff’s attention to people who had been incontinent. Staff then had to wait for other staff to be available before they could leave the communal area and provide support. We also had to intervene on two occasions when people were not being supported with their meals and had to bring staff’s attention to people who were cold and needed more appropriate clothing. However, this was not observed across all units, and we spoke with the management team about the unit where issues had been observed. We also saw some examples of good practice. For example, when a person said they were hungry, the staff member immediately responded giving them a choice of snacks. We also noted call bells were answered in a timely way.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.