Nazareth House - East Finchley

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

People were supported to live their lives the way they wanted to. Policies and procedures in place meant people were at the centre of all processes within the home.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At our last inspection there were no structured activities in place to ensure that people were stimulated, and their wellbeing maintained. This was a breach of Regulation 9 (person centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Enough improvement had been made and the provider was no longer in breach of this regulation. Most people were positive about the range and number of meaningful activities on offer in the home, although some people told us they did not enjoy them. We observed people participating in a choir session. They were given a song sheet to assist them and it was run by an activity co-ordinator. A person said, “[Activity coordinator] is so lovely.” Other comments were also positive about the activity staff in the home. We noted that people sang along and enjoyed it. There was a chapel within the home which offered various church services for people who wished to attend. A programme showed that the home could offer activities and entertainment such as bingo, arts and crafts, religious services and music. A person said, "There is an option of going to Mass everyday and I like the activities.” The provider made sure people were at the centre of their care and treatment choices. Staff and leaders worked in partnership with people, on how to respond to any relevant changes in people’s needs. Decisions were made in consultation with people so they were in control of their care needs. A person told us, “The staff are kind and caring.” People and relatives told us they felt involved in the development of their care plan and they were asked about their preferences and wishes. A relative stated, “I am happy with the level of care.”

We observed kind and caring interactions between staff and people. There was a level of respect shown by staff towards people and their relatives. We looked at people's care plans and found them to be mostly detailed with information around people’s needs involving, for example, activities and socialising, communication, dementia, continence, mobility, eating and drinking, weight plans, personal care, dementia, skin integrity, sleep, falls, oral hygiene and sleeping. However, we did not find a consistent approach towards making sure staff followed people's care plans accurately and in accordance with their needs. For example, if people required repositioning in their beds at certain intervals, records showed these were not done to reflect the care plans. For a person on 2 hourly repositioning over a period of 3 days, care records showed they were not being repositioned enough or that staff had not recorded they had repositioned them as required every 2 hours. We found similar occurrences for 2 other people where records showed they had not been repositioned as per the interval and frequency guidance in their care plans. This put people at risk of not receiving care that was tailored for them.

The provider had systems to make sure the diverse health and care needs of people in the local community was joined-up, flexible and supported choice and continuity. People's equality and diversity needs were respected. Each person had their own individual characteristics, wishes and preferences. These were explored and recorded in personalised care plans. However, some further work was in progress to make sure care plans were consistent and that the guidance within them was being followed. We found some concerns in relation to monitoring people's repositioning and fluid intake. Care plans were reviewed and changes were made when people's needs or risks had changed. We found most care plans to be be up to date.

The provider had a policy for the application of the Accessible Information Standards (AIS). This meant the service supplied appropriate and up-to-date information in formats that were tailored to people's individual needs and were accessible to them. For example, easy read or large print versions of information about the service. Staff were aware of people’s communication needs. For example, if people required support to verbally express their thoughts, guidance was in place for staff to follow. People told us their communication needs were known by staff. A member of staff told us how they used body language and gestures to communicate with a person. People’s communication abilities were recorded in their care plans.

The service had processes to make it easy for people to share their feedback and ideas or raise complaints about their care, treatment and support. People told us the manager and staff listened to what they had to say and took on board their feedback. During our visit we observed staff engaging in conversation with people, and listening to them. Staff were friendly, respectful and caring towards people.

People and their relatives told us they were involved in discussions about the care they received and that requests and preferences were respected. There were meetings for people and relatives where they had opportunity to air their views. Items discussed included meal times and choices, activities, laundry services and the home environment. Complaints about the home or the service were investigated and responded to in accordance with the provider’s procedures. Some people and relatives told us they had never felt the need to raise a complaint or were not sure how to complain, but we saw records to show that information on how to complain was available. Some relatives told us they were confident the management team would respond to any concerns they had. A relative said, “There has been quite a bit of change in management recently but all is good, as I make sure that there is a paper trail of requests.”

The service made sure that people could access the care, support and treatment they needed when they required it. People we spoke with told us they were promptly referred for additional support if it was needed, for example for tissue viability assessments, speech and language therapists and physiotherapy services.

The provider of the home followed processes to ensure people's human rights were respected and they all received fair and equal treatment. The provider had a strong Catholic ethos and they worked with the Sisters of Nazareth convent that was connected to the home, to help support people with their religious needs. This included a daily mass service, although it was for people to choose whether they wished to attend. The home welcomed people of all religions and records showed this was the case as we noted people from multiple faiths in residence. People told us they were treated fairly and had equal access to services, such as the health care they needed. Care was tailored for each person and they received support and treatment with their goals and aspirations considered. This would help to produce positive outcomes for them. Staff told us care plans helped them get to know people and their likes, dislikes and specific cultural or religious needs. Care was tailored so that people's protected characteristics were considered and respected. This also included people's sexuality, self expression or their preferred gender identity. Staff were provided with training on equality, diversity and inclusion to raise awareness of people’s rights. Staff told us they understood that people could likely experience inequality and discrimination based on their religious views, gender, race or sexuality for example. Staff and leaders took into account people who are likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. People and those close to them felt empowered to talk about things which mattered to them and impacted on their health and wellbeing.

Care planning procedures ensured staff had access to the information they needed and care plans were regularly reviewed. People had individual plans of care which were personal to them and included their future wishes should they require end of life care or palliative care. This included funeral arrangements and preferences relating to their support and treatment at the end of their lives. Where people's end of life wishes were in accordance with their faith, this was acknowledged and respected. Staff told us people’s care plans provided them with the information needed to ensure people’s wishes were respected. Staff had received training about how to support people at the end of their lives. Some people had authorisations in place such as Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) which took into account each person’s individual circumstances and their preference for what action should be taken in the event of a cardiac arrest for example.