Archived: Rainscombe Bungalow

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

Care records were not detailed around the physical care people received. There were also gaps in the provision of supporting those with communication needs to have their opinions and choices heard. This therefore did not maximise the choices for people with a learning disability in line with RSRCRC guidance. Staff demonstrated poor understanding of how to deliver person centred care. During our assessment of this key question, we found concerns around people not receiving person centred, evidence-based care specific to their needs

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a mixed response from relatives and advocates on how people were supported with activities and person-centred care. One told us they felt their loved one was going out more based on the information they were given by staff. Other comments included, “X likes to go out for a drive but going out for a drive doesn’t achieve anything and I don’t know what else X does” and “There could be more abstract things happening….” A further comment was made about the home environment stating, “The set up of the bungalow is odd, not homely.”

Staff told us they try and ensure people have access to activities however their understanding of meaningful activities for people was lacking. The registered manager said they had been working with staff to improve activities for people and had contacted outside services to help with this. They said, “There is a lot more work to be done with activities.” Staff did not have good knowledge of the backgrounds and life histories of the people they supported. One told us, “I would like to know so if someone asks me (I know).”

People’s bedrooms were homelier than on the previous inspection. However, the lounge area remained stark and lacked a homely feel. During both days of the visits, people that remained in the home had very little to occupy them. We found were either just sat in the kitchen, lounge or their bedrooms. We saw that people were going out more to activities, but these were not always meaningful. There were frequent references to people going on drives or walks. Some people were now going out more to cafes, but activities were not always provided in line with people’s preferences. For example, there were multiple preferred activities in 1 person’s care plan that included, drives, walks, puzzles, arts and crafts, at home exercises, shopping, live music, baking and listening to particular music. The majority of activities the person participated in over 3 months were drives and walks.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People did not have information provided in a format that they would understand. A relative and advocates fed back on this. One told us they had provided a communication aid for staff however they were not confident this was being used. Another told us, “I have suggested the use of more pictorial aids for example food menus. That will enhance a person’s life.”

Staff had a lack of understanding of how best people communicated. For example, 1 person they told us, “We tell X what’s going on” and “With X they do Makaton signs such as food, drink and outside.” Another member of staff just told us, “I haven’t seen anyone using Makaton here.” The registered manager told us they did not use any alternative communication aids and that they were seeking advice from external professionals in relation to this. However, this was a concern we raised at the previous inspections and sufficient action had not been taken. Staff were also not aware of the significance of people’s visual impairments and how this impacted on the people.

During the Assessment we did not see staff using any alternative communication aids for people. We asked if we could see the communication book that a relative told us they had provided but no staff were aware of this or where to locate it. There were people that were visually impaired, yet we did not observe any audio communication aids for them. According to 1 person’s care plan it was suggested by a health professional that they had a bright contrasting plate and place mat to assist with their sight. This was not in place. It also stated the person should wear a hat outside to reduce the sun glare to assist with their vision. Staff were not aware of this and only thought the hat was needed to stop the person getting too hot. They told us the person did not always wear a hat when it was bright outside and were also unable to find the hat.

Relatives and advocates were not routinely asked for their feedback of care. We asked for evidence of surveys and feedback request, and these were not provided.

Staff were routinely recording on care reviews that they were unable to get people to be engaged. There was no information on how they were trying to engage people. The registered manager told us all people were allocated a key worker and they were supposed to have monthly meetings with the person they were allocated to. They said however, these meetings were only taking place with 1 person.

People were not always encouraged to feedback any areas for improvements. We saw people had monthly key worker meetings and a template was completed to prompt discussion. However, there was no prompt to ask them about things they would like to change or see improved. The key worker meetings involved discussions about people’s goals and aspirations however there was no evidence these were being looked into to see if what could be done to achieve these. As stated, the key worker meeting had only taken place with 1 person.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.