Rowan and Magnolia Wards

The majority of people on Magnolia Ward were unable to engage in conversations with us due to their varying degrees of dementia, we therefore spent the majority of our time observing staff interactions with people. Staff interactions were observed to be kind, respectful and unhurried.

We observed the lunch time experience to see how patients on the ward were supported to make choices following concerns raised at the last inspection. We noted that significant improvements had been made which had resulted in the patients being able to make informed choices and to enjoy a more relaxed and sociable dining experience. Staff were observed sitting with patients who required support and prompting to eat. One member of staff was observed taking meals to people and they checked that each individual was happy with their choice of meal. We saw that patients were able to change their mind if they wished. Sauces were offered at the time of serving the meal and a choice drinks were offered throughout the meal.

A menu, along with photographs of the meals had been displayed in a communal area. This meant that patients had a daily reminder of the day's menu in an appropriate format thus enabling them to make an informed choice.

An orientation board provided patients with information about the day, date, season and of the names of the staff on duty.

At the last inspection we found that care plans relating to the management of certain behaviours did not contain sufficient information which would ensure that individuals received a consistent approach to care.

Improvements were noted at this inspection. Care plans seen contained more detailed information and also included any 'triggers' which might exacerbate certain behaviours. Clear information about how behaviours should be managed had been recorded which meant that patients would receive a consistent approach from staff.

Patients are now provided with opportunities to say how they would prefer to be supported whilst on the ward. On admission to the ward staff meet with patients to discuss and document their preferences relating to daily routines, diet and activities. Information is reflected in individual's care plans thus ensuring that staff can deliver a more person centred approach to care.

People on Rowan Ward told us that they were 'always treated with respect' and that staff respected their privacy.

The majority of people on Magnolia Ward were unable to engage in conversations with us due to their varying degrees of dementia, we therefore spent the majority of our time observing staff interactions with people. Staff interactions were observed to be kind and respectful and we saw that staff knocked on people's bedroom doors before entering. Those able to mobilise without staff assistance were observed moving freely around the ward. We observed the lunch time experience to see how people were supported to make choices. We observed a staff member plating meals from a hot trolley and were informed that people had made their meal choice earlier in the day. Plated meals were placed in front of people and we did not observe staff checking whether people were happy with their choice. We saw that puddings were served with custard without asking people if this was what they wanted.

People on Rowan Ward told us that they felt 'safe' and that they were satisfied with the care they received. People on Magnolia Ward were unable to express their views in the same way as those on Rowan Ward but we observed those on Magnolia Ward to be comfortable in their surroundings and in the presence of staff. People on Rowan Ward confirmed that they would be comfortable in raising any concerns or worries with the manager or a member of staff.