St Audrey's

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’s care was not person-centred. Relatives did not always feel listened to. People’s communication needs were not fully considered when providing information and their end-of-life care wishes were not always discussed or reviewed. People were not always supported to access relevant health services to meet their individual support needs.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care was not person-centred. There was a lack of information in care records about people’s backgrounds and preferences and activities were not personalised. There was no evidence of involving people and those close to them in care planning. Some people had care plans for conditions they did not have, such as asthma and some monitoring charts were completed unnecessarily as the risk to the person was not recorded in their care plans. However, 1 person’s showed they had expressed their preferences for staying in bed and refusing any further interventions in relation to their medical condition and this decision was followed.

The provider told us all care records were being reviewed as they transferred to a new electronic system. This included ensuring information was personalised. They told us, “We are reviewing for each area of the care plan. That includes all risk assessments. We have re-allocated all new key workers for each resident – they have been tasked with life history. They will meet with relatives/friends to really capture background history – activities co-ordinator will be pulled into that too.”

We did not observe staff providing people with support which reflected their needs and preferences. Staff interacted very little with people during our visit and with the exception of 1 staff member, the few interactions we observed were poor.

People’s care records contained limited information related to input from other health professionals involved in supporting their needs.

The provider told us they planned to attend the next MDT meeting, having missed them for the past 6 months.

Other professionals who provided support to the service found staff had not received enough training and identified gaps in people’s records. A professional told us, “Tasks such as care plans, keyworker allocations and training was not being promoted or followed up…the staff disclosed to me that there has been no recent training offered… I do feel the staff want to have the opportunity for training and want to be able to move forward with the home and the care they provide.”

The provider told us they had made improvements to the referral process following the site visit. They said, “We have put a system in place where if a referral needs [to be sent], we have a communication book and when that referral goes the central team are aware and can track the progress of that. We are keeping that as part of a referrals file, so we have the evidence there. If we get communication from other professionals, we are adding it to the original referral…any GP notes are going on to new system as progress note and then into the outcomes.”

People did not always receive information in formats to support their understanding. A relative confirmed people were offered a choice of meals, but this was only done verbally, and it was felt the person did not understand. They told us, “I’ve been in there and the staff ask what [person] wants for lunch. I don’t think [person] understands what they are saying.”

The provider acted in response to our feedback regarding information displayed for people. An old activities planner and example menu were removed to avoid confusion and a visit from the quality officer was arranged to discuss residents’ preferences for menus.

The information on display relating to activities and menus at the time of our visit was not effective to support people’s understanding. This was amended following our feedback.

People’s relatives told us the provider had not actively sought their feedback. They felt they had to be proactive for their voices to be heard, and the provider was not always responsive to issues raised. For example, a relative said, “I feel I have to write to the area manager to get to know what is going on.” Another relative told us, “I did have to mention a couple of bits… but it wasn’t done until I got shirty about it.” However, people’s relatives did confirm they were aware of ways to provide feedback and how to make a formal complaint. A relative said, “Yes, there’s leaflets, there’s the QR code. Email of manager.”

Staff told us people were able to give feedback on the service. A member of staff said, “I believe they have for those with capacity and think those without, the family or next of kin involved in their care they are able to do that. They get feedback all the time get to tell them what has happened in the course of the week.”

The provider’s process to gain feedback from people was not robust. They had completed a resident survey which people had received support from staff to complete. This meant we were not assured people’s responses were valid. There was no analysis of the responses, or any evidence of action taken where feedback was given. The provider’s complaints log showed 2 complaints received in the past year. Not all concerns had been addressed and there was very limited evidence of investigation or outcome and shared learning.

People had call bells in their rooms to alert staff if they required help. During the site visit we noted these were responded to quickly. For those unable to use a call bell, we saw records of regular wellbeing checks. The premises were fully accessible and there was lift access to all floors.

The provider understood people’s right to equity in accessing care and support. They told us, “This is an area to consider as different residents move in with different needs. We will capture this as part of our current resident reviews too.”

Health and social care professionals told us they were involved with the service and provided input into people's care and support.

The provider had policies to ensure compliance with human rights requirements. This included consideration of the needs of people with different protected characteristics and how to make reasonable adjustments to ensure equity.

People were not always supported to engage in meaningful activities which met their individual needs and preferences.

The provider told us some people had 1-1 time allocated as required to support an equal experience. They told us, “[Person] does get 1-1 time with staff and support on conversations do happen. We need to get better at it terms of evidencing how it looks.”

The provider had started to review care records for all people. This process included identifying any potential inequalities in experiences and outcomes.

People’s wishes at the end of their life had not always been discussed or reviewed.

Staff were able to describe how people were supported with end-of-life care. “Each individual has their own requests. Some may not want to be taken to A&E or not for resuscitation. We have to work as per care plan. We do mouth care. Administer fluids so they don’t have dry throat. Re-positioning. Some we do personal care; we have to give pain relief. Some they have morphine.”

People’s care records did not always include details of their wishes at the end of their life. We reviewed 4 people’s care plans and 2 had no end-of-life care plans. Another person did have an end of life care plan, but it lacked detail; it stated they had a DNACPR, and no further discussion had taken place as they did not want to discuss it. This conversation was held in August 2020 and there was no evidence it had been approached since. However, 1 person had an end-of-life plan which included details about their wishes and preferences for care towards the end of their life and after their death.