Archived: April Cottage

Some of the people who used the service talked about hobbies and activities they had been involved in like watching their favourite football team on television, going for a walk down the lane and noting the animals seen on the journey or talking about technology.

We spoke with relatives representing all of the seven people who used the service. It is contrary to Care Quality Commission (CQC) policy to identify individuals in our reports and some relatives were concerned about repercussions if their comments were identified. As there were only a small number of people that the unit could accommodate, reporting here regarding the number of people who said what, may identify them, so we agreed that numbers will not be recorded here against relatives' comments.

Some of the relatives told us that they were kept informed and involved, felt their relative was cared for well, was safe at April cottage and they had no complaints but would feel listened too if they did. Some people were worried that making a complaint would be taken out on their relative.

Most of the relatives told us that they were not kept informed and when asking for feedback either received inconsistent responses from staff or no response at all.

Most of the relatives felt there were not enough activities in and outside the home provided by April cottage. Some of the relatives told us that the activities room was used as a storage room and was never used for activities unless the relatives took the initiative themselves and set an activity up

Some relatives raised concerns about things not getting handed over and a lack of records, for example records of activities, communications and visitors.

Some relatives raised concerns about staff seeming disorganised and it not being clear what the management hierarchy was.

Some relatives also said they felt the increased use of agency staff who did not know the home and residents also contributed the varied quality of communication and records.

Most of the relatives that had negative comments also made positive comments.

We saw that that people were usually but not always provided with privacy and dignity. People who use the service were given appropriate information and support regarding their detention status and rights, but people who used the service and their relatives were not always given appropriate information and support regarding their care or treatment. In addition, the service did not provide appropriate opportunities, encouragement and support to people who use the service in relation to promoting their autonomy, independence and community involvement.

We noted that people's needs were assessed, care and treatment was planned in line with their individual care plan and there were arrangements in place to deal with foreseeable emergencies.

We found people who use the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises because the Trust had not maintained the building to a working and safe standard as they had not provided some bedrooms and communal areas with door closing devices to facilitate fire and smoke protection systems, and they had not removed ligature areas assessed by the Trust as environmental risks to people who use the service which therefore needed to be removed or made safe

We saw the provider had effective monitoring and audit systems in place to regularly assess and monitor the health and safety of people, but was not monitoring and reviewing the quality of service that people receive. In addition, the provider had not created an environment where people were confident that they would not be discriminated against for raising concerns.

We found people were not always protected from the risks of unsafe or inappropriate care and treatment because people's records were not always accurate and fit for purpose and records could not always be promptly located when needed.