The Radcliffe

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

Improvements were required to ensure people received person centred care. People told us they were not able to have regular baths and showers, which records confirmed. This had improved by the second inspection visit but provision of baths and showers was still infrequent. Staff and leaders did not always demonstrate a good knowledge of providing care to people living with dementia. The service was not always adapting information to ensure it was in line with individual communication needs. There was a complaints procedure in place and people told us they did not have any complaints at present. During our visits, people were mostly engaged in activity by staff. People made positive comments about activity provision.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People gave us examples of when they felt staff had supported them in a person centred way, but we found examples where care provided was not person centred. People's comments included, "Last week I went out to an appointment and they had saved my dinner for me and they warmed it up for me." Another person said, "They always say what do you like the best and I like the Mirror newspaper. They have time to talk to me."

We received mixed feedback from staff with some stating that they knew people well and others being unable to give us information regarding people and their needs.

We observed that although staff were kind and respectful, they did not know enough about people to deliver them person centred care.

We received mixed feedback from people and relatives in relation to people accessing baths or showers. One person said, "When I first came I had a bath, but have not had one since. I have no shower and I am just washed." Another person told us, "I can have a shower once a week." Relatives told us, "I have had to ask if [person] has been washed. Yesterday person had dirty clothes. We asked and [person] has now had a bath."

In our conversations with the registered manager, we found they had not been monitoring the care provided to people. As a result, they had not identified that people were not always being offered or provided with regular baths and showers in line with their preferences.

The local authority had shared concerns identified after their monitoring visits. These concerns included shortfalls in medication, staffing, infection control and people's personal care not always being recorded. These issues had been shared with the registered manager. During our assessment, we continued to find concerns with personal care. Not only the quality of the recording but also how frequently it was being offered to people.

Care was not always provided in a person centred way, particularly for people living with dementia. People told us and we saw evidence that regular baths and showers were not happening. On our second visit, we found some improvement in this area, with several people having baths/showers. However, these were still infrequent and not in line with people's preferences. After our visits, the nominated individual told us the actions they were taking to ensure that people were regularly offered and provided with showers and baths. Staff and the registered manager did not seem knowledgeable about providing good dementia care. The environment was not adapted or designed to support those living with dementia to navigate around the building independently. People were observed asking where their bedrooms were. This evidence indicates a breach of Regulation 9 (Person Centred Care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People and relatives did not raise concerns about accessing information. However, we found very limited evidence to show the provider was adapting the way they provide information to people to meet their communication needs.

The registered manager and staff did not show a good understanding about the need to adapt communication to meet people's specific requirements. We found communication care plans had not been put in place where these would have been appropriate. We observed staff administering medication without explaining or adapting their communication when supporting people living with dementia. The registered manager told us they were planning to offer staff additional training in this area and the nominated individual explained the steps being taken to review the care of people.

We found limited evidence to show the provider was adapting the way they provide information to people to meet their communication needs. We found that food menus were pictorial, to support the choice of people living with dementia. However, no other resources were in place or had been used to ensure people living with dementia had access to information in a way they could understand. People who had sensorial difficulties or lived with dementia did not have a specific communication care plan to make sure staff understood their needs and met them in a person centred way.

We received mixed feedback about people being involved in planning and reviewing their care. One person said, "I have seen my care plan." A relative told us, "They do discuss [person's] care plan." However, another relative said, "There has been no discussion about the care plan." People told us they did not have complaints about the service.

There was a complaints process in place and the registered manager was able to explain us the steps they would take if they received a complaint. There were no records of complaints received by the service.  

There was a complaints process in place and the registered manager was able to explain us the steps they would take if they received a complaint. There were no records of complaints received by the service. Residents meetings were taking place. However, we found a lack of processes in place to ensure people and relatives were involved in planning and reviewing the care received.

People told us they were treated fairly. A relative told us, "[Person] is on build up shakes. The [staff] would get [person] a doctor if [they] needed one. Every Thursday the hairdresser comes. [Person] has the chiropodist and [their] nails done."

The registered manager and staff knew who to contact when people's needs changed.

Partners did not raise concerns in this area.

People were supported to live healthier lives by accessing relevant external healthcare when needed. In our review of people's care, we found people were being referred to and seen by their GP and some people were under the care of district nurses and specialist care teams. During our visit, the opticians visited the home and reviewed people's eye care.

People shared mostly positive feedback about being able to make choices and be involved in activities. However, we found the service needed to make improvements to make sure people who required additional support were equally supported.

Staff and the manager could not demonstrate robust knowledge about providing good dementia care.

The environment did have good signage which did not facilitate people living with dementia to find their bedrooms unaided. People were observed asking where their bedrooms were. People’s care plans did not always have detailed information about their communication needs, how their health conditions impacted on their communication and how staff should support people to make choices.

People and relatives did not raise concerns about planning for the future care of people if their needs deteriorated or they required end of life care.

The registered manager told us they were in the process of reviewing care plans with regard to planning for the future. They displayed a knowledge of who they could contact for support if someone using the service was approaching the end of their life.

At the time of our assessment, there was no one living at the home who required end of life care. In our review of care plans, we found these did not include information about planning for the future. The registered manager told us they were in the process of reviewing care plans and knew they could contact the GP, district nursing team and the palliative care team if a person living at the home required this level of support. Do not resuscitate orders were recorded in the summary of people's care.