Courtyard Mews

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

We identified one breach of regulation in relation to Dignity and Respect. People's choices and preferences were always not met and respected. Timings of care calls did not always reflect people’s choices and some people told us that requests for changes in their support were either slow to be implemented or not facilitated. People’s communication needs were not always adequately assessed to ensure staff could understand choices and preferences. People were not always supported to manage their health in ways that ensured this was done safely or effectively.

This service scored 62 (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.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People received poor outcomes, the service they received was not caring; people's needs were not assessed, reviewed or met. People were not consulted, their concerns were ignored, and they told us about care calls in which their wishes were not respected. Some people we spoke with expressed concerns about the service and staff not always respecting and facilitating choices and preferences. One person said, “Sometimes they (staff) bring in someone to shadow a carer, they don’t tell me or ask if I mind. I come downstairs in the stair lift and there's someone else here. I think it would be polite.” Another person told us, “I say to them please let me know if there's different carers and they don’t. Times change. I have to repeat myself. I have asked to change care teams and nothings improving.” Some people informed us that they could not recall receiving a visit from the service to review their care and ensure that their needs and preferences were being met or receiving questionnaires to feed back their views. One person said, “I’ve not spoken to (manager). I can't recall them calling of visiting to review the package.” Another person said, “I can't remember them coming, I can't remember anyone coming. Can't remember who manager is.”

The registered manager did not promote independence, choice and control for people. There was a lack of detail in communication assessments and associated care plans. For example, the care plan for a person living with dementia did not detail how this condition affected them, how advanced their dementia was and how staff could best support them. Staff were referred to the person's family to make decisions on their behalf. This left the person at risk of receiving support against their wishes. Communication care plans and assessment tools were not person-centred, one person's communication assessment concentrated on how staff could communicate with them but did not detail how the person was able to communicate back to staff. Staff told us about how they supported people and encouraged them to be more independent when delivering tasks such as personal care. One carer said, “It’s about encouraging them to do things by themselves. For example, personal care, we give them the flannel so they can wash part of themselves and so they can be part of their care.” Although some staff provided feedback to inspectors, we received information during the assessment process that the registered manager had told some staff not to answer their telephones from inspectors. It had been alleged that only friends and family who are employed by the registered manager were to provide feedback to CQC. We cannot be assured of the validity of this feedback.

People were not supported to manage their health and health needs to promote independence, choice and control. Staff were not provided with risk assessments and associated care plans that gave them information about people’s health care and risks, staff could not fully ensure that the care they provided was supporting people’s needs in a caring and effective way. Communication care plans did not effectively ensure that guidance was in place to maximise people’s ability to convey choices and to ensure that staff were able to communicate fully with people. One person was assessed as finding it difficult to communicate their needs verbally but there was no information or guidance for staff on how to maximise ways of communicating and seeking views or consent. The registered manager confirmed that they did not support anyone with activities and community support or with maintaining contact with family members.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

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.