Stoneyford 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 requires improvement. This meant people’s needs were not always met.

Improvements had been made to the safe and responsive care that people received however there were still improvements to be made in relation to person-centred care being consistently delivered and documented. While professionals who worked with the service such as GPs and district nurses complimented the care and support, their guidance was not always accurately recorded or followed by staff which placed people at ongoing risk.

This service scored 57 (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 had made improvements to how they delivered and communicated person-centred care since the last assessment, however we observed and received mixed feedback during this inspection. People told us their care plan reflected their needs and they and their loved ones had been included in planning and updating this record on a regular basis. Relatives meeting minutes and feedback from relatives told us the provider was working hard to provide online access to care plans for people. However, on the assessment we spoke to a person and their relative who had experienced a room change and personalised equipment had not been moved from the previous room to the new room as needed. Staff acknowledged this had affected the person’s care and their ability to be independent. The management team responded and ensured the correct equipment and support was in place.

While improvements had been made, there were some shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined-up, flexible or supportive of choice and continuity. Professionals who worked with the service, like district nurses, told us the staff team were knowledgeable and responsive to people’s care needs which kept them safe and provided good outcomes. However, records did not always accurately reflect external professional advice and did not accurately demonstrate how staff undertook or followed this advice. For example, one person had returned from hospital and needed to self-isolate for 24 hours with their temperature being taken hourly for that period. Records showed temperature checks were not taken for the first 15 hours. The person told us they remembered having their temperature taken however records did not support this, which placed the person at risk of harm.

Improvements had been made to how the home supported people and staff with accessible information. Staff feedback told us that their concerns over security of information within the home had been addressed and improvements had been made to communications including emails. Relatives told us the management team were more responsive to verbal requests for information and updates about their loved one but there remained at times a language barrier. One relative said, “I asked staff for an update recently and [staff member] looked at me blank, sometimes it is hard as medical terminology can be difficult to describe, but there was another staff member about to help. It takes time and staff are learning quickly.”

People and staff told us the provider had made improvements to the culture of the home, and they were now confident to raise concerns and told us they would be supported to do so. One staff member said, “The management team are really approachable now, we can talk about things before they become a concern or issue and it’s dealt with quickly.”

However, complaints were not always dealt with in the same manner. The provider had a clear complaints policy in place. We saw evidence in records of a relative raising concerns which were acknowledged by the provider’s head office team but there was no evidence or records of a review, outcome or additional contact with the relative from the staff within the home.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. While we saw evidence that the staff and management team raised identified concerns that were promptly raised and referred to medical professionals, records did not show the ongoing support staff provided whilst professional medical support was obtained. For example, staff identified a person with redness to their skin, which is a sign of potential tissue damage which could lead to a pressure sore. Staff contacted the district nurse team to alert them. However, there was no further records of checks or repositioning done by staff to prevent further tissue damage prior to the district nurse visiting which placed the person at risk of harm. People we spoke with did confirm that staff were responsive and supportive with requests for GP appointments.

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. Everyone we spoke with told us the culture of the home had change and become more open and inclusive. Staff told us they were now supported with reasonable adjustment to enable them to return to work quickly and safely following periods of sickness. We saw evidence of appropriate risk assessments to support people and staff with personalised needs, including appropriate support for pregnancy and disabilities.

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. While no one was receiving end of life care at the time of the inspection, staff had received training to support knowledge and care delivery should this need arise. Care plans gave detailed guidance for staff about people’s wishes or who they wished to be contacted to make these decisions at the appropriate time. Staff were knowledgeable about people’s wishes and were aware of appropriate tools such as Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms and supported people to complete these where appropriate. The ReSPECT process creates a personalised recommendation for clinical care in emergency situations. The form is clearly documented and regularly reviewed with professional involvement including GPs.