Angel Mount 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

People’s communication needs had been considered and people were being cared for in a person-centred way. The service, including people’s bedrooms, had been personalised and people’s own preferences had been considered. Referrals were made to other healthcare professionals and complaints were reviewed and analysed. Staff felt people were cared for well and regular reviews of care plans took place, alongside people and their relatives. However, concerns were raised about the communication between staff and relatives and not all relatives were aware of meetings or feedback forms.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us they had been involved in the care planning process. One relative said, “I am regularly included in details about [person using the service] care including the care plan and any changes they make.” Relatives complimented staff for accommodating people’s wishes and tailoring their care to suit individual preferences. Comments included, “When they realised how important the garden is to [person using the service] they moved the room around so that they could see into the garden” and “(The staff) allow the activity to fit [person using the service.” Relatives said care was extended to them as well as the person. One relative said, “The home is so caring, they even rang me up last week to see if I was OK because they hadn’t seen me for a couple of weeks.” Relatives praised the personalised painted murals in people’s bedrooms. One relative said, “A mural was painted on the wall after 1 week, personalised to [person using the service]. [Person using the service] sits next to it and strokes the dog.” The relative went on to say how this brought the person comfort.

Staff understood the meaning of person-centred care. The registered manager told us they had purchased birds for the garden as people enjoyed seeing them and they had plans to enhance the garden space with a bar area and ballpark. Staff spoke highly of the gardens at the service and how this enhanced people’s wellbeing. Staff also praised the painted murals in people’s bedrooms and around the home. One staff member said, “The atmosphere is really good, everyone has their life history in their rooms, the home has murals, this makes people feel at home, happy and comfortable.” The registered manager told us people and their relatives were involved in writing and reviewing their care plans.

Thought had gone into the design of this service to ensure it was person-centred. Most bedrooms had painted murals on the walls which were tailored to people’s preferences, for example, someone who supported a specific football team had this painted and another person had a picture of themselves and their dog. Each bedroom had an electronic screen which displayed prompts for staff such as preferences, names of loved ones and their life history. Painted murals were present around the home and included a bakery and post office as well as quiet corners with seating for people to relax should they wish. The service had been designed to cater for those with dementia and the gardens included a ‘bus stop’ which promoted memories of people waiting for a bus and to provide comfort to those who were distressed and felt they needed to go somewhere. During our inspection we witnessed staff providing people with a choice and the layout of the service allowed for people to decide where they would like to spend their time. Bedroom doors were painted and personalised so they could be easily identified and pictures of people were displayed around the service which made it feel more homely and person-centred.

Relatives felt people would be referred to the appropriate healthcare professionals, should they need to. One relative said, “(Staff) referred to the dietician in a timely manner and the occupational therapist.”

Staff felt confident any concerns would be acted upon. One staff member said, “If I was concerned about someone’s health I would inform the nurse and they would make any referrals.” The registered manager told us how they worked with other professionals to ensure people received the best possible outcomes.

Partners said referrals were made to their services and feedback was taken on board.

We saw evidence in people’s care records of referrals being made. This included the community mental health team and various other services. These referrals and outcomes were evidenced in people’s care records and were shared among the staff team through daily handovers.

Relatives told us there was a communication issue between themselves and staff. One relative said, “I’m sorry to say it but I do struggle with the language. I can’t understand what they (staff) are saying sometimes and it feels awkward. Especially as they are such good carers.” Other relatives spoke of the difficulty of speaking to staff over the phone. One relative said, “We have tried to speak to the (registered) manager but they don’t work weekends. We have been told we are welcome in the week but work patterns don’t allow this so it has to be phone contact which isn’t the easiest.” We spoke to the registered manager and the operations manager about this during the inspection process and they advised they would be speaking to all staff about ensuring they speak to relatives in a quiet environment and that arrangements were made to ensure all relatives could attend any meetings in person should they wish to. The registered manager also said she would speak to staff about escalating concerns to the nursing staff and directing relatives to them for any clinical questions.

Staff understood the Accessible Information Standards and told us how they used other forms of communication including white boards and picture cards to communicate with those who were non-verbal. Staff understood the need of keeping personal information private. One staff member said, “(Staff) never discuss residents in front of other residents.”

The Accessible Information Standards were being followed and documents were available in easy read and large print formats. Staff had training on communication and record keeping and detailed communication passports were in place. Personal records were kept secure and people’s privacy was respected.

People and their relatives knew how to raise concerns should they need to. Relatives recognised the changes that had been made to this service and felt they were positive. However, not everyone knew about relative meetings or feedback forms. One relative said, “I don’t know about any relative meetings but there used to be a newsletter which was informative. Not for a couple of months though.” Another relative commented, “They seem like a good team there, although I don’t remember being asked for feedback.” Other relatives told us they had attended a recent relative meeting and completed feedback forms. We informed the registered manager that there appeared to be a lack of communication in this area and they provided assurances that people and their relatives would be sent feedback forms and invited to any meetings.

Staff told us they promoted decision making by asking the person what they would like to do and said they were confident in escalating concerns. One staff member said, “If a resident (is) not happy about something, I would report this to the nurse. We talk to people and try and understand them.”

Records of complaints had been analysed each month and included a summary of the outcome, and any action taken. Verbal complaints had been documented as well as lesson learnt which had been shared amongst the staff team. The lessons learnt feedback discussed practice and active listening and prompted staff on how to handle complaints professionally. We saw evidence of relative meetings and feedback forms completed by people and their relatives, staff and visiting professionals.

Relatives feedback was not always positive in this area. Some relatives felt care staff did not always act on signs of deterioration but felt confident in the nurse’s ability to escalate concerns. However, some relatives were confident they were kept updated. One relative said, “They (staff) keep us informed of anything that happens and they call for permission to organise things likes jabs or outings.”

Staff felt there was enough staff to safely care for people and that cover arrangements for staff sickness or annual leave were arranged swiftly. Staff felt they could care for people in a relaxed way without feeling rushed. Staff spoke about preventing social isolation for people who stay in their bedroom. One staff member said, “[Person using the service] likes colouring and seeing pictures. Staff sit and colour which makes [person using the service] smile as they can no longer do this themselves.”

Feedback in this area was mixed and concerns were raised about the environment. One partner said, “The layout of the home and the high volume of 1-1 support can create a confusing and very busy environment.” However, another partner praised the environment. They said, “The environment feels calm, staff are there when people get agitated and take feedback on board.” The registered manager took this feedback on board and was looking at ways of creating a more relaxed environment.

Contingency plans were in place and there appeared to be sufficient numbers of staff to meet people’s needs should there be an emergency. Care plans held evidence of reasonable adjustments people required and guided staff on how best to support them. People who could not access the communal areas or who were cared for in bed had specific plans in place to ensure they received person-centred care and treatment.

People and their relatives told us they had been involved in the care planning process and that their feedback was sought during reviews of these records. One relative said, “I am regularly included in details about [person using the service] care, including the care plan and any changes they (staff) make.”

Staff told us they had no concerns about the service or of people’s care provision. One staff member said, “It is a great place, the residents come first but we work as a team. I would be very happy for family to be cared for here.” Staff knew how to support people who had concerns and to express their views.

We saw evidence people’s care records had been reviewed, alongside the person and their relative. Care plans held a record of people’s preferences and a log of visits from healthcare professionals. Feedback forms evidenced positive feedback obtained from relatives and praise was given for the accessible garden space.

Relatives told us they had been consulted about people’s end of life wishes. One relative said, “The office requested copies of all our paperwork including DNACPR (Do Not Attempt Cardio Pulmonary Resuscitation) and LPA’s (Lasting Power of Attorney) and they do know [person using the service] wishes.” Another relative spoke of how they, alongside the registered manager had created an end of life plan to reflect their loved ones wishes.

Staff were aware of plans being in place for people’s end of life wishes and advised they had completed training in this area.

A policy was in place for end of life care planning. Care plans held information on people’s advanced wishes and staff had completed training in this area.