Gillingham Road

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

At our last inspection 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. The service was in breach of legal regulations in relation to care records not being detailed around the care people required, people not being supported to lead fulfilled lives, there were also gaps in the provision of supporting those with communication needs to have their opinions and choices heard. This therefore did not maximise the choices for people with a learning disability in line with RSRCRC guidance. Staff demonstrated poor understanding of how to deliver 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.

People and relatives did not always feel staff supported people with day-to-day activities. Comments included, “I like going to the cinema, but they still haven’t sorted a cinema pass for me” and “[Person] gets bored and gets frustrated.” Staff told us they accepted another person would refuse activities that were meaningful to them and that the person preferred just to be on their own. However, there was no guidance in a person’s care plan on how to encourage them to do this. One person had a schedule of activities for the week however their care notes did not reflect these were taking place. Often the ‘activity’ was walking, day centre, shopping or picking up the person prescriptions. Care plans had limited information on people’s life histories, likes, dislikes and interests and staff we spoke with lacked knowledge of this.

People did not always experience continuity in relation to meeting their needs. The provider/registered manager had failed to involve mental health professionals when they moved into their homes particularly when they had experienced a recent mental health crisis. When another person recently moved, the provider/registered manager had failed to involve a professional to support creating a positive behaviour support plan that was more specific to the person’s independent living. The provider's processes to ensure people's ability to be integrated into their local community needed improvement. We received feedback people's activities were not always promptly organised, for example one person's ability to go out was affected by the lack staff available in the evenings. We were not assured these concerns had been identified by the provider's own systems to ensure their effectiveness.

People did not always have information provided in a format that they would understand. One person, who preferred easy read versions of documents, told us they did not have a copy of their care plan and would like this. The provider/registered manager had not provided them with an easy read copy of their care plan or any other easy read documents. A relative told us they had not been provided with a copy of the care plan and had only been briefly shown one on the staff handheld device. Other than an activity schedule in picture format the person’s family provided, there was no other easily accessible information for the person who would have benefitted from this.

People were not always encouraged to feedback any areas for improvements. We were told people had monthly key worker meetings however there was no record of this. We saw the provider/registered manager met with 2 people to undertake a review of their care; however, these were infrequent. There were no surveys provided to people, relatives and stakeholders to provide feedback to make improvements.

People were not always supported to access the community in a way that meant something to them. For example, one person told us they were unable to go out in the evening as there was not a member of staff available to support them with this. They told us, “No [can’t go out at night] I need a carer with me, and they are only sleeping staff.” We found people did not consistently receive the support around RSRCRC, as we found not all people had good access to local communities that most people take for granted. Processes were not always effective in ensuring each person had the same equity in access. Although some people were supported to access external professional support, this was not consistent and as such meant that not everyone was being given equal opportunities. There was a lack of evidence each person's self-defined strengths, preferences, aspirations and needs as the basis on which to provide care and support to live an independent life was undertaken. For example, we found no evidence that any reasonable adjustments had been made to ensure people had access to health care. One person had not seen a GP since they started receiving care with the service. The provider/registered manager had not followed up with the GP for them to do a home visit.

People did not always have the opportunity to experience things that meant something to them. One person told us they would like to go to the cinema and told us about their preference for the films they liked watching. Staff also told us they were aware of this. However, despite this, there was no record of this person ever being supported to travel to the cinema. Staff did not always make an effort to enable people to participate in their preferred activity.

The majority of people that were being supported were young and did not have life limiting conditions and as such were not asked about their end of life wishes. However, for the people that were older, there was no information in their care plan around their wishes for end-of-life care.