St Nicholas 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 provider met people’s needs.At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.Care plans were person centred and included information about people’s needs and preferences. One person told us, “The staff are very kind I like them all. They know everything I need. They know what time I like to get up and go to bed.” Staff understood people and meaningful relationships had been formed with them and their family members. We observed positive interactions between staff and people throughout our assessment.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People said they had access to a range of health and social care providers when needed. Healthcare professionals commented on the positive partnership working they had with the service. One spoke to us about how this had improved in recent months and said, “My instructions are carried out in a timely manner. Staff are friendly and I work well with them.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For example, menus were available in dining rooms, however these were only available in written format and some people were unable to read them. Staff did read out menu choices to people however, one person told us they would like their menu to have pictures of the options available. We raised this as this would assist people in their decision making and promote independent choice. The management team told us work was in progress to address this.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Regular meetings were held with people to enable this. Staff involved people in decisions about their care and told them what had changed as a result. A complaints policy was in place and information on how to make a complaint was clearly visible. All concerns and complaints had been taken seriously investigated and appropriately addressed. Some people told us they did not know who to complain to, however other people told us, “If I had a problem I would go to [the registered manager], they seem approachable,” “I’ve no concerns but if I did, I’d tell whoever was in at the time” and “I have nothing to complain about, anything not right I’d get [the registered manager] over and tell them.” Family members told us the provider had been open and transparent following the last inspection they told us the provider had explained the reasons for the previous rating and told them actions which were being taken to address the failings. One family member commented, “I have nothing to complain about. We had a meeting after the last inspection. They told us everything.”

The provider made sure that people could access the care, support and treatment they needed when they needed it. Partners who worked with the provider told us people received care when they needed it. Records were maintained when people accessed support from other services. Where appropriate, important contact details were contained within care plans. A family member shared their appreciation of the registered manager for securing additional care funding. They told us, “[The registered manager] got more funding to look after [Name]. They worked hard to get this.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For people who were at the most risk of inequality in experience or outcomes, information about people’s individual care and support needs was recorded. We did identify some shortfalls in the level of detail within the care plans for some people who experienced periods of distress or confusion and how best to support them effectively without resorting to the use of medication. We did not identify anyone who had medication inappropriately or excessively administered, however we discussed with the registered manager some care plans needed further improvements in this area. Most people and their family members were generally positive about the care they received from the staff team, although some experiences differed across the different areas of the home. For example, some people told us staff responded promptly to requests for care. One person told us, “[Staff] come fairly quickly if you buzz them.” However, other people told us there could be a delay in staff responses. Comments included, “It depends how busy they are, sometimes you wait a long time if you press the buzzer, and they seem a bit impatient when they come in” and “Staff are a good lot. I sometimes have to wait a while because they are busy with other people.” We shared this feedback with the registered manager who showed us a new call bell system which was about to be fitted which meant they could improve the monitoring of response times to improve care.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Some people had shared details about their plans for the future. This included end of life care wishes and whether they had chosen to have do not attempt cardiopulmonary resuscitation (DNACPR) order in place. These wishes and arranges were clearly documented. One family member told us of their recent experiences of staff approaches towards their loved one at the end of their life. They told us, “[Name’s] care was outstanding.”