St Stephen's 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 service met people’s needs. At our last inspection we rated this key question requires improvement. At this assessment this key question has improved to good. Not all people and their relatives knew how to make a formal complaint if they needed to, and information was not always available in an accessible way. Most people told us they would share any concerns with their relatives. Care plans did not always consistently demonstrate people and relative involvement. The service gathered feedback from people, relatives and staff through regular service surveys and meetings. People had end of life plans in place, which detailed their wishes and preferences.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us they were unaware of what care plans entailed and some said they had not participated in any reviews. People did tell us they had been part of an admission review but were not part of any regular updates. Relatives told us, “We were advised prior to admission, someone from the home visited with the social worker”. Care plans reflected people's interests, likes and dislikes and described tasks they liked to do themselves. For example, one person enjoyed helping with the laundry and became a member of the domestic team performing different laundry duties.

Managers told us people and relatives were involved in regular meetings and were updated with changes to people’s care needs. However, this was not always clearly demonstrated in people’s care plans. For example, regular reviews took place of people’s care plans, but records did not show who with, and what was discussed when the reviews took place. We did see when people had had falls or changes made to their clinical care needs, relatives had been informed.

We saw staff had good knowledge of people’s needs. However, we observed 1 person specified to a staff member they did not wish to have either choice on the menu and asked for an alternative, which was agreed by the staff member. During our lunchtime observations, the person did not receive the meal they asked for and was given a meal which was on the menu, this was not person-centred care. People's social interests, the activities they enjoyed doing either at home or in the community were documented.

People told us they were involved in activities and enjoyed people coming into the service from the community. Comments included “love it here, love the garden, like singing” and “My relative takes me out, we go over with friend and a member of staff to local pub for lunch”. One person told us they would like to access the community more as they have not been out since their admission.

Managers told us they understood the diverse needs of people. The service was linked with a local church where people could either attend in person, or a church service was provided once a month in house. The service also worked alongside a local nursery where children visited and spent time with people living at the service.

We gathered feedback from Healthwatch, the Local Authority and safeguarding team who said the management at St Stephens Care were working with them to provide information regarding some concerns which were raised prior to our assessment.

People’s care records demonstrated the service had worked with other health and social care professional services to ensure continuity of people’s care. Admission assessments had been completed prior to people moving into the service.

We did not see consistent evidence of people being involved in care planning, and not all information was informative and tailored to people’s individual needs. For example, we did not see any information being available in an accessible way for people who had hearing or sight impairments.

The registered manager told us they share information and updates about the service within relative and resident meetings, which was evidenced.

People’s care plans contained guidance on how they would like staff to communicate with them. One person had communication cards to use in their own language. However, during our visits staff did not make any attempt to use the cards to provide the person with information about their care, despite the person regularly seeking out staff members. Key information such as the service’s complaints process and how to raise safeguarding concerns were not shared in way which was accessible to all people.

Some people were unsure of how to raise a formal complaint directly with the home. One person told us, “I have no information about making a complaint, I would go to my relative who would advise me. Where relatives had raised a concern with waiting for long periods of time at the front door, CCTV had been purchased to alleviate the issue.

The registered manager told us people and relative’s views were sought through regular meetings, which were documented. We saw evidence of relatives having been informed of a new registered manager and any relevant safeguarding information. The registered manager had asked relatives for their involvement with care and end of life planning, but this was not always reflected in people’s care plans.

There was a complaints policy in place. Staff recorded complaints and concerns received and documented actions taken in response to these. We noted there were no formal complaints raised with the service. Nevertheless, the service provider recorded other concerns raised by people and their relatives in a “grumbles log” and recorded actions taken to prevent concerns from escalation. However, not all people were able to raise complaints in an accessible way.

Some people told us they could access the relevant healthcare treatment if needed. One person told us, “The doctor visits every Wednesday from the medical centre, I ask staff if I want to see them”. Relatives told us they were also aware of regular GP visits.

Managers and staff told us they would support people to access care, support and treatment when people needed it. This was evidenced in people’s care plans.

External professional shared the service made appropriate referrals in a timely manner. They told us the service communicates well.

The service worked in partnership with other professionals to meet people’s needs. Referrals were made to other external professionals when required, for example Neurologists, District Nurse’s, Occupational Therapists and GPs.

Overall, people did not raise any concerns in relation to experiencing inequality in their experiences or outcomes. However, one person told us how they missed going out alone and wished they had more shops locally which they could access.

Staff had completed equality, diversity and inclusion training. Staff told us and we observed people had access to a communal courtyard. There were flower beds and a gardening group which people accessed as part of an activities programme. We observed staff supporting people to prepare for a themed event the following day after our first visit.

People’s care plans contained information about their wishes in relation to their social, cultural and spiritual needs. These included people's sexuality and preferred daily lifestyle choices. People were enabled to participate in activities in the service and where able, some in the wider community.

Peoples wishes had been sought regarding their end-of-life care and treatment. Where people had chosen not to discuss their wishes, this was also recorded in their care plans.

Score: 3 Staff were aware of which people were receiving end of life care and completed the relevant end of life pathway training.

There were systems in place to record people’s advanced wishes. These included funeral arrangements and people’s choices regarding resuscitation in the event emergency treatment. Staff had spent time discussing people's wishes with them and, where appropriate, with their families.