St Annes Residential 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 good. At this assessment the rating has changed to inadequate. This meant services were not planned or delivered in ways that met people’s needs.

People were not routinely included in the planning of their care. Care remained task driven with people having allocated bath or shower days. While staff were polite when interacting with people, we did not see staff responding in person centred ways. Staff were task driven.

The service was in breach of legal regulation in relation to person centred care.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At our previous assessment we found that peoples care records were not always current and care plans lacked detailed information on how people needed to be supported. People were not routinely included in the planning of their care. At this assessment we found very little had changed. We saw care records were overdue for review. There was no improvement to the care plans. No action had been taken regarding involving people in the planning of their care. Care remained task driven with people having allocated bath or shower days. While the people we spoke to expressed that they were generally happy with their care, our assessment found elements of care did not meet the expected standards. This was discussed with the registered manager who said it was, “more convenient for staff to have a list.”

When we asked staff if people had choice, for example, could people choose when they had a bath or a shower a staff member told us, “No, they don't. Some of them they don't really like the water. We have a list. And that's great. I like the list. With the list they have anyway two days per week shower.”

However, staff also said, “At 3pm it's always teatime. They always have cakes, biscuits, snacks, everything. They always choose what they want to have. We don't choose for them.”

The service was quiet, with activity focussed in one room and people stayed in their rooms for a lot of the day. We saw staff follow guidance and check in on people. However, while staff were polite when interacting with people, we did not see staff responding in person centred ways. Staff were task driven.

People did not always have mental capacity assessments when staff felt they lacked capacity. Staff lacked understanding of the mental capacity act and did not help people to make choices about their care. This means that those without capacity were at risk of not having their care needs met and people with capacity were at risk of staff making decisions for them.

The registered manager had not arranged for dentist visits for people, so their oral health was not managed. The registered manager had not sought advice on medicine's management, for example, input from a pharmacist. A senior staff member told us there were no routine pharmacy visits to assist in the management of medicines.

The local authority had not raised specific concerns about care provision and continuity offered to people living at the service; however the local authority quality monitoring team was working with the service to address wider issues found.

Care plans were not written in a way that enabled staff to provide consistent support to people. There were gaps in the care plans, there was conflicting information within the care plans. Audits and checks had not identified these shortfalls. Risk assessments were not always completed and did not provide staff with guidance to mitigate the risk.

We spoke to people with limited and failing eyesight who told us they wanted to be able to access books. While they were able to access books via a specific charity for the blind, they said this was limited and it could take a long time to obtain a new book. The management team had not arranged any other audio book access, such as the library or streaming services.

We discussed communication, for example with people who may have sight or hearing difficulties. A staff member said there was training but it was a couple of lines with multichoice answers, they said, “To be honest I just read enough to pass.”

The service relied on staff talking to people to remind them about menus, or changes at the service. When surveys were carried out people were not always able to access them in ways that were suitable for them, with the registered manager relying on staff helping people complete the surveys. This meant people might not be able to provide honest feedback about any issues they had.

People were accepting of the care provided. They did not have complaints when asked as they felt staff were busy and doing the best they could. There was a lack of curiosity from the management to speak to people to find ways to improve the care they received.

The registered manager had not operated an effective complaints system. Concerns and complaints were not documented. When asked how complaints were monitored the registered manager told us, there was, “no audit of complaints,” and “no log of complaints.” They also said, “To be honest, we don’t get a lot.” When we asked how complaints were responded to the registered manager said they were, “not able to evidence this,” and “had no oversight.”

Basic questionnaires had been distributed to people and their relatives; however, the registered manager was not able to evidence they had used feedback from people, relatives and those important to them to improve and develop the service. The registered manager had previously suggested anonymous feedback boxes at the service, however this had not been implemented.

Staff did not understand equity. People were treated equally, however this meant people with specific needs did not have them addressed. For example, people with allergies were not able to eat meals prepared by staff at the service with everyone else, because everyone had the same meal options with no allergy consideration.

A senior staff member told us they had no specific management training. A senior staff member said in the past there had been keyworkers allocated to people who were able to get to know them well and tailor their care to them, but this no longer happened.

The local authority had not raised specific concerns about equity for people, however the local authority quality monitoring team was working with the service to address wider issues found.

There were standard policies in place to ensure that people had equity in access. However, policies were not always followed. The service was run by a Catholic order and accepted people from all religions or none.

People’s feelings were not accepted or supported. For example, a person told us they disliked the service and wanted to leave. Their views were dismissed as staff believed they lacked mental capacity.

When asked about how people were able to remain connected to the community a staff member said, “The care home does not really support community contacts due to not enough staffing and cost. People have TV in their rooms.”

There were no processes in place to monitor people’s experiences or ensure there was equity in outcomes for people.

People were not included or involved in plans for the service. Staff did not respond to people’s plans for the future. A person told us they were getting married in a few days time. There was no evidence of this in their room, no cards or decorations. They also told us they were moving to a new home, however the registered manager had not mentioned this to us.

The registered manager told us the action plan created after the last assessment had not been completed because they hadn’t had time.

Care plans had space to record people’s end of life wishes. However, this was not routinely completed. The registered manager had created an action plan for the service after the previous assessment had found the service required improvement. However, this action plan had not been followed.