Cavell Court

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

Staffing levels matched the expected levels in line with people’s dependencies and we observed people receiving care in line with their needs. Relatives appreciated that breakfast was served at people’s own pace and was in line with their preferences. We found however lunch did not run so smoothly with people needing assistance having to wait and staff running back and forth to the kitchen. The deployment of staff across the home was not observed to be effective at busy times of the day with some staff attempting to assist more than one person with their meal at a time. This resulted in functional rather than person centred care. Activities were planned across the day, but we did not observe much structure with the first activity not starting until later in the morning and not inclusive of everyone's needs. One person told us they did not like any of the activities on offer and some staff either did not know what activities were taking place or said they were not always appropriate. Care staff were not observed supporting activity staff to deliver a programme of activities. There were no evening activities, but this is something the management team said they could introduce as this was something they already had in place at their other homes. Staff told us they started assisting people to bed after tea and although this might be some people’s choice the introduction of evening activities might encourage people not to retire so early to their rooms. Whilst there was a programme of activities over seven days a week and great facilities within the home including a café, cinema room and library. These could be used to greater effect. Events were held throughout the year to celebrate notable dates in the calendar. Peoples care records were person centred and linked to their previous life histories and experiences. Records also included thinking ahead should people become ill or need increased 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.

One person told us about their life experiences and said they did not feel staff recognised their experiences because of age and cultural differences. Our observations across the day were mostly positive but we did have concerns about how staff did not always have time for people or spend time listening and validating their feelings. For example at mealtimes and across the day when most people were unoccupied and interactions with staff were fleeting. We discussed this at feedback and said staff could have spent more time interacting and discussing for example, what was on the television, It was the Olympics and taking time to reminisce with people. People were supported to access the care they needed. One person told us they had access to their care plan, and this was discussed with them. People told us residents meetings helped to ensure they could be involved with the planning and delivery of the service. There was evidence showing how feedback collated had been acted upon. One relative told us different sexual orientation was recognised and celebrated and the home recognised people’s religions and background.

We observed some poor staff interactions and received feedback from relatives that their family member were not always supported in the way they would wish, in terms of personal care, social engagement and having staff that were familiar with their family members needs. The manager told us what they were implementing actions to improve the service and to ensure it focused on value-based care from robust recruitment, to tackling poor practice to help ensure everyone received good quality care which was person centred. Mentoring and modelling good behaviour was in place and sought to improve peoples care experiences. Discriminatory practices were addressed if identified. Staff told us they were supported according to their individual needs which took into account culture and protected characteristics.

We were not assured that staff practices were fully inclusive of people’s experiences. For example, we saw some poor practice around inclusive activities and ensuring people were given the support to engage in activities in line with their needs. We also observed functional care, poor manual handling and poor meal time experience.

Access to the home was good and relatives were encouraged to be involved with their family member’s care. Groups from the community used the service but we were unable to see how this was inclusive to the people already living at the service. People told us about activities undertaken including pets as therapy, arts and crafts, outside entertainers and celebrations such as valentine dance and trips out. Newsletters helped let people know what was available and the activity schedule was well publicised. The manager had appointed well-being leads and was keen to develop a fully inclusive team. Relatives feedback about activities were mixed, one relative told us they had improved, and another told us, " My relative is not given the opportunity to go out. There are not enough staff to do things."

There were multiple ways the home engaged with people including surveys, resident meetings, relatives’ meetings, care plan reviews, etc. There was a detailed newsletter and online social media connecting families and used to share infomation about events. People were aware of the meetings and dates were advertised in advance. (it was suggested to the manager that relative/ resident meetings could be chaired by someone other than the manager which might encourage more open discussion etc.) A resident of the day was in place, which could be more effective when a key worker ( named staff member ) had been fully implemented.

Feedback from partners was that the service was integrated into the local community and took full benefit of services offered. People could access their own support or use a range of domiciliary services and regular support from the GP surgeries.

Ideas were collated from people using the services with input from relatives. The manager said the activity schedule was put together a year in advance so things could be booked and different activities evaluated to see if they were enjoyed. We noted in peoples records that there was a record of activities people had engaged with which included one to one interactions throughout the day, which is important in recognising how people's social needs were being met.

People had access to paper records which were used to record their daily needs. One person told us they had a copy of their care plan and people were 'resident of the day' when their needs were reviewed and people could comment on how satisfied they were on all aspects of their care. We reviewed these and found them informative but not always completed by all key members of the team or demonstrating how suggestions for improvement had been acted upon. Family members were involved in these reviews where people had agreed this.

Staff had lots of opportunity to give and receive feedback and be involved in the development of the service. Information was accessible around the service. Establishing a more robust key worker (named staff for each person) would strengthen communication and accountability. Some staff said they were not key workers and others said they had been the named key worker for a person but had since moved suites so had limited knowledge of what was happening for that person.

There were multiple ways the home engaged with people including surveys, resident meetings, relatives’ meetings, care plan reviews, etc. There was a detailed newsletter and online social media connecting families and used to share information about events. People were aware of the meetings and dates were advertised in advance. (It was suggested to the manager that relative/ resident meetings could be chaired by someone other than the manager which might encourage more open discussion etc.)

Complaints were well received and acted upon and people seemed well informed about who and how to complain. Team leaders and unit managers managed the day to day environment and people told us they were comfortable to talk to them. People told us they had very few concerns. Families were well informed and felt able to raise concerns although, several family members felt that sometimes the same issues were being raised such as the quality of food, however relatives did say this had improved. Relatives felt there was always someone they could talk to and said they were asked to contribute their feedback.

Information was accessible and available throughout the home. People and their families were well informed about what was happening in the home. Staff were well informed but most chose not to go to staff meetings due to their shift patterns and days off. This meant that they missed the opportunity to get to know other staff well from other floors and share good practice across the home. Staff received a lot of information electronically. The manager told us that pre-admission assessments and introductions to the service were robust to help ensure people and their families had the information they needed to make decisions about the suitability of the service. We observed families being shown around and been given full information about the facilities available. Several families had said people did not always use the facilities and the manager had responded by explaining what staff did to try and encourage people. The service had a reception area and visitors were greeted and signposted to where they wanted to go. We found this was helpful and the receptionist was knowledgeable.

The manager told us that following a pre admission assessment people could spend time at the service and see their potential room, join in for lunch over a period of time. Full information was requested from the GP so staff were aware of the persons medical history and any medicines the person was taking. Copies of the assessments were shared with families who could contribute to the information gathered particularly in terms of social and family history. On admission, people were monitored for a while to help ensure staff could establish a base-line of their needs particularly in relation to their likely food and fluid intake and any support they might need. Welcome packs and service user guides gave people and their families the information they needed. The manager said families were invited in for a service review every six months. In addition, there were monthly reviews and annual surveys. Feedback was sought and fed into action/ improvement plans.

People were supported to access the care they needed. One person told us they had access to their care plan, and this was discussed with them. People told us residents meetings helped to ensure they could be involved with the planning and delivery of the service. There was evidence showing how feedback collated had been acted upon. One relative told us people’s different sexual orientation was recognised and celebrated and the home recognized people’s religions and background. One person told us about their life experiences and said they did not feel staff recognised their experiences because of age and cultural differences.

Discriminatory practices were addressed if identified. Staff told us they were supported according to their individual needs which took into account culture and protected characteristics. Staff told us concerns raised were dealt with. The manager told us what actions they were implementing to improve the service and ensure actions focused on value-based care from robust recruitment, to tackling poor practice to help ensure everyone received good quality care which was person centred. Mentoring and modelling good behaviour was in place and sought to improve peoples care experiences.

Partners told us staff organized lists in advance to ensure people's changing or unmet needs could be reviewed and teams worked holistically with regular multi disciplinary meetings.

The provider had policies in place around the adherence to human rights and safeguarding to ensure people were fairly treated and lived without the fear of discrimination. Staff received training in human rights and person centred care and there were processes in place to monitor those standards of care and support people if the standards of care fell below what was expected.

Care plans recorded essential information and were reviewed with the person to ensure they remained relevant.

Staff were complimentary about the care and support people received and said things had improved recently.

Processes were in place to incorporate people’s experiences and views and support people to settle and share their ideas and live out their lives in the way that met their needs. People were supported to maintain outside interests and access to the local community. Community groups were able to use the facilities and relatives were able to stay over in an emergency and meet family members in the tearoom. Events such as the valentine ball helped bring people together. Newsletters and resident/ relative meetings helped to share news and publicise events. People were supported by staff to access their support and to have and receive visitors and or health care professionals as needed.

People’s needs were assessed before admission and kept under review. Bedrooms were spacious and highly personalised and people encouraged to maintain their independence. Staff described the home as a step ladder of support with each floor having a slightly different level of need and staffed accordingly. One relative told us as their family needs changed so did the floor which they felt better suited their needs. Careful balancing of people's needs and risks were carried out regularly and discussed in the daily risk meetings.

Staff received training to support people with a range of conditions and had good support from the primary care teams for ongoing medical support for certain conditions. We saw some complimentary feedback and a case study of how the service had supported people approaching the end of their life and ensuring care was holistic.

Care plans took into account peoples wishes and aspirations for the future. It also took into account what people might want to happen should they become ill. Relatives spoken with felt well informed about their family member’s care.