Paul Murphy Centre

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 involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people were not always support in a person-centred manner. The provider was in breach of legal regulation in relation to person-centred care.

This service scored 71 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Care was not always planned to ensure the provider was meeting people’s current needs and preferences and longer-term aspirations. Care records did not record information on how staff should support people to promote independence. People using the service, and those close to them, were not regularly involved in planning and making decisions about their care and treatment. The provider had not continually gathered information from people’s representatives to ensure care was truly person-centred. For people who attend college, the provider was involved in reviews with the educational setting to plan for a person’s future, but it was not evident these plans were adopted across the home to ensure people led a full and active life. The provider did not hold a copy of the individual’s Education, Health Care Plan (ECHP) which is a document that outlines the support a person needs to achieve their goals. The care plan assists in identifying both education and health and social care needs and sets out additional support people need. Positive behaviour support plans (PBS) were in place for some people, but they did not always capture strategies to understand and manage behaviours and identify suitable ways for people to increase their skills and improve their way of communication. Some staff were not always aware of who had a PBS plan. One staff member told us, “I know what they are vaguely. I think they are on the (electronic care planning).” Staff were not always aware of how people should be supported to achieve their goals. One staff member told us, “As far as I am aware, there are reviews. We have staff meetings each month and we received feedback on their goals. Any updates go into the (care) plans, but I am not involved so I couldn’t comment.”

The provider aimed to understand the diverse health and care needs of people. People accessed health and social care support when they needed it. Staff facilitated any emergency or scheduled appointments with professionals.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information was available to people in an accessible format which included easy read formats of complaints processes. Communication care plans lacked detail about how people should access information in an accessible way. One person’s care plan recorded they use a picture book to help with communicating and they were able to point to specific pictures to talk about, but this person didn’t use the book at the home. The provider had not considered developing the person’s communication using other tools and skills such as sign along, talking mats or objects of reference to make communication meaningful.

Complaints were listened to and responded to. Regular meetings were held with people living at the home, but we were not assured everyone was able to activity contribute to the meetings as no advocates had been invited to support people to make their views known. We observed staff verbally providing information to people. We did not see any feedback obtained from people or their representatives.

We did not find there were barriers to people accessing urgent health care and support when they needed it. We did note where people had swallowing difficulties, health professionals were not always contacted in a timely manner to ensure people were in receipt of the most appropriate dietary support. We found the provider did not always fully understand the restrictions placed on people when they were unable to leave their bedroom by themselves and this barrier had not been fully considered when planning care and support.

The provider did not always actively follow guidance to support people who were more likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. The provider did not always support people to access community activities in the individuals’ best interests. One person loved to swim but hadn’t been supported to access the activity for a long time. Another person had a detailed activity plan but there was little evidence activities were occurring. The was a lack of planning to ensure people were supported in line with right support, right care and right culture guidance for autistic people and people with a learning disability. Care plans did not always give enough information to support people safely. The current model of care was not consistent with best practice.

People were not always 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. There was little evidence people were actively supported to make decisions about their future. Family and representatives were involved in their relations care but there were no plans and goals set to ensure people’s independence was maximised. End of life care plans had not been discussed; however, one person did have a funeral plan in place.