Bowerfield House

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

People were generally happy with how they were supported. However, it was not always evident that people were receiving care that was personalised to their needs. Further improvements were needed to ensure people had consistent support with personal care and ensured a good standard of oral care.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were treated kindly and staff knew people. However, it was not evident that care was personalised to people’s needs and preferences. We noted examples of people’s likes and dislikes were not being consistently met. For example, one person cared for in bed liked to have sensory lights on but this was not being followed and these sensory lights were not on during the multiple occasions we visited the room. Some people’s specific care needs such as repositioning and mattresses settings were not always being followed and there was not always evidence that personal care needs were being fully met.

Staff generally knew people and were able to engage with people. Some staff were able to deliver very personalised care but some other staff interactions were less personalised.

We observed that care provided was generally positive but was not always personalised to a person’s specific care needs and preferences. For example, in terms of the levels of support people needed and how activities and conversations were personalised to a person’s interests and preferences.

People told us they received consistent support from staff. People were supported to access some external services where needed and there were regular reviews with the GP and other medical professionals.

Staff understood the importance of working together with other agencies and sought advice and support where this was needed.

Partners did not raise any concerns with us in relation to how care was provided to people.

Referrals to external services were made. The provider had completed lessons learnt and identified areas for further development and early intervention in response to some incidents.

People were happy with how they were supported and involved in the service. We noted some families new to care provision told us they felt welcomed and supported by the service.

The management team had a good understanding of how to ensure communication with the people using their service. They recognised the importance of this and knew how to meet the Accessible Information Standard. This meant that people were given information in a way they could understand. Staff told us that the provider ensured access to a wide variety of resources to support good communication.

The provider was able to access a wide variety of approaches to ensure information was accessible for the people they supported. This including adapting written information and arranging for translation services. The service had access to pictorial menus but these were not seen in use during the inspection.

People generally felt able to raise concerns. Some families told us they were involved in resident and relative meetings and had received surveys. Some families felt that concerns had not always been resolved as quickly as they could but that the new manager and consistent staff team had led to improvements. For example, discussions regarding the use of the conservatory areas had taken place with relative meetings for many months and action was still ongoing to make this room into a usable, multi-functional area for people.

Staff spent time speaking and listening to people. Generally, where people were able, they were encouraged to get involved in activities with the home and make choices about their daily lives.

The provider completed surveys. A display board with action taken in response to feedback was in place near the manager’s office. A complaints policy was available and generally, where complaints had been raised, these had been appropriately addressed.

People felt they were treated with equity and were content with the service they received.

Staff spoke positively about people and wanted to provide the support people needed.

Partner agencies had no concerns in regard to people using the service having equity in access.

Processes were in place to ensure people’s needs were met. The provider was completing ongoing work to further improve good practice and address any issues with a culture of poor practice. This work was ongoing.

People were happy with the support they received. However, the experience of people varied depending on where they spent their time in the home; with those spending time in their bedroom, or on one unit, disadvantaged. People who spent in time in communal areas, especially on the ground floor had access to more stimulation and activities and had better of oversight of their needs from staff.

Staff told us they encouraged people to engage in activities and opportunities. We saw examples where staff were responsive to people’s and family’s requests if something specific was wanted.

The provider had clear processes in place to ensure equality. However, at the time of inspection evidence of how the provider ensured people supported in the home had equal access to services, experience and outcomes available need further development. For example, people did not have equal access to activities and opportunities to go out in the community. Access to care services such as physiotherapy to reduce people’s fall risk or dental input to support oral care was not always available.

People were not clearly engaged in discussions about plans for the future or care they wanted at the end of their life. We noted that whilst staff were kind and caring, people with higher levels of needs, cared for in bed were not always kept comfortable. For example, there was not always enough oversight of people’s skin integrity and pressure needs, or that people in bed were comfortable and not unsettled or at risk of a fall from their bed.

Staff generally understood how to support people approaching the end of their life.

It was not always evident that processes were used to support people and families to be involved in planning for the future. Care plans for people receiving palliative care, for example, were generic and task-based and did not evidence the involvement of others. There were processes in place to ensure people had the support they needed such as medication to keep them comfortable and nursing staff understood when these medicines should be used.