Whitstable 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

Staff did not always provide care which was responsive to people’s needs. When people’s needs changed the guidance for staff did not always change within people’s care plans. Staff did not respond to people’s requests or to concerns raised by other health and social care professionals.

This service scored 43 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care plans and risk assessments did not always contain personal information such as people’s choices and preferences. People told us they had not always been asked their preferences and some of their choices had been ignored. People gave examples of how they had not been involved in making decisions about their care including restrictions such as bed rails.

Staff described how they supported people in a person centred way, by asking their preferences and choices. However, this was not always people experience. People had not been supported to be as independent as possible. The management team had assessed people to identify when people had skills and could be more independent, such as managing their own medicines.

We observed staff supporting people with their meals, staff did not always respond to people’s requests. For example, one person told staff they did not want anymore food, but staff encouraged them to eat more, and they spat the food out. The person was then left sitting in the dinning room with no staff support. Staff had not supported the person as an individual and treated their support as a task which needed to be completed.

Some people told us staff did not always understand their needs and people felt they were not always supported safely. People described occasions when staff had not moved them safely using equipment. People expressed concern some staff did not always understand what they were asking and just carried on without considering their feelings.

Staff described how they referred people to other professionals when their needs changed. However, people did not always feel this had been done appropriately and their thoughts and feelings had not been considered to have the best outcome for them.

The local authority raised concerns about how staff provided care and responded to guidance from professionals. We were informed of the concerns, the local authority confirmed the service were working with them to make improvements. Concerns were raised by other stakeholders about people’s care and support, they had report these concerns to CQC and the stakeholders were now monitoring the service and people's outcomes.

The processes in place to ensure people’s care provision met their needs were not effective. There was limited oversight of the quality of the support being offered to people, or the management of any concerns raised by people. The management team did not always respond appropriately to concerns raised by other professionals, they had not acted quickly to recognise genuine concerns and how this was impacting on people. Following the assessment, the provider told us, all staff would go through the induction process again, we will review this during our next assessment.

Information for people to find their way around the building was not dementia friendly for example there were no pictorial signs. People we spoke with did not require any different forms of communication. People's needs had not been assessed appropriately, those who had additional needs, including the need for pictorial signage, these were not referenced in people's care plan.

Staff described how they would communicate with people. However, this did not include how they communicated with people who had additional needs. The management team had not ensured this additional information was available in people's care plans, or recognised this was a shortfall.

There were processes in place to record how people needed their information to be presented. However, this had not always been completed in people's care plans. The management team had not ensured there was pictorial signage and information around the building.

People told us they had not been involved in the service. Comments include, “There doesn’t seem to be anyone in charge. Who would you go to? If you ask, you’re told “they’re in a meeting, not here, on holiday.” Another person told us, “There are no residents meetings. I’ve never been asked about my views. I think there should be a way to put our views forward.” And “I’ve never had a questionnaire and there aren’t any residents, meetings that I’m aware of.” Other people we spoke with confirmed they had not received questionnaires or attended meetings.

Staff told us they listened to people and spoke with them to know what they would like. But this had not been what people had experienced while living at the service.

Though the provider had processes in place these had not been followed at the service. People had not had the opportunity to attend meetings or give feedback on the quality of the service. People had not been involved in giving feedback when writing or reviewing their care plans.

Most people living at the service were registered with a private GP who visited the service regularly but was not local. There was a risk people may not be able to have a visit from their GP when they needed if they became unwell outside of the times the GP visited the service. People did not have the opportunity to visit their GP service for appointments if they wished as the private GP was not based near the service.

Staff told us representatives from the GP surgery including the GP visited weekly to discuss people’s needs. Staff told us they reported to the health professionals any concerns they had about people and gave updates on any treatment.

Health professionals from the GP surgery attended the service several times a week and it was confirmed people had been referred to them when needed,

There were effective processes in place to work with the GP visiting each week and discuss people’s needs. People who required GP input had received this during these visits and staff discussed people's needs and progress.

One person told us, “No, I don’t think the residents are treated equally. I think. there are some residents that are favourites and others that aren’t liked. The women that are sat around the TV don’t get the same support that others do.” We observed people in wheelchairs were not sitting in the communal lounges, they were sitting looking out the windows at the sea.

The management team explained how they monitored people’s quality of care. However, these checks did not look at the outcome for people and people’s quality of life. The management team had not considered people's experience living at the service as part of these checks.

People’s care plan did not contain information about people’s additional needs which may affect their experience and outcomes within care. There were not always effective processes in place to check people had access to appropriate health care provision and what may be needed to support people. People’s health conditions such as Parkinson's disease had not always been considered to make sure they had access to appropriate healthcare.

Care plans had clinical details such as if there was a do not resuscitate document. However, there was no evidence people, or their relatives had been involved in a conversation with staff about their choices and preferences such as who they would like with them, music they wanted played and any other personal requests people may have.

Staff described how they spoke to people about their wishes such as which funeral directors they wanted to be contacted. However, people had not been asked about any personal wishes or preferences to make their end of life experience as they would like.

People’s care plans contained a section for end of life care, this contained very basic information about what staff should do once the person had died. However, the processes to make sure people were asked about what they wanted to happen when they were receiving end of life care, were not always effective.