The views of people who use the service varied, with considerably more negative responses from people who live in or visit relatives in the Rydal unit. None of the people or relatives spoken to were aware of their rights to be involved in making decisions about their care and treatment. None of the people spoken to knew what a care plan was and no one could recall staff talking to them and asking them what they thought about the care they receive and how it is delivered. We looked at several care plans over the three day visit but could find no evidence of involvement with people living at the home, either with initial care planning or monthly reviews.Some people we talked to were positive about living at the home but all these people lived upstairs in Derwent unit. One person said, 'it's marvellous here', they told us that had really enjoyed Christmas and felt that they were well looked after by staff. Another person told us that the home was, 'first class, home from home'. This person said they were unaware that a care plan existed about them and also told us that they were woken up at 4am every day for a wash, but did not know why this could not be done at a later time.
Several relatives told us that communication in the home between them, staff and management was poor. One relative told us that when they had a meeting with the area manager at the home, their relative's private room was 'spruced up' in readiness; the carpet cleaned and new bedding found.
Some people living at the home, ( all upstairs in Derwent ) told us that they liked the food. One person said, 'its marvellous, really nice'. Another person said she had enjoyed the food available over Christmas. Two people told us that the food was, 'alright' but usually tasted the same whatever it was. People told us that they have no input into what is on the menu and are not asked if they like the food.
One relative told us that they had not been asked by staff what food their relative liked or disliked. This meant that the home could not develop a nutritional care plan in line with their preferences. They also said that there had been no discussion of how their needs could be met due to a visual disability. They told us that they had seen people struggling to have a drink and that although staff go round with drinks they do not offer any assistance to actually have a drink.
A visitor told us that only people who have visitors are offered soup; people with no visitors are given their main meal straight away. On Christmas Day and Boxing Day the lunch was served early but visitors were not informed so it was finished when they got there. Some visitors queried this with staff but we were told that staff responded rudely. One person was very worried that their relative had not had any lunch as they 'weren't there to feed them' and they didn't have confidence that staff would have fed them.
Some visitors told us people living in Rydal are never offered a biscuit with a hot drink as you would expect, mid morning, mid afternoon and at suppertime.
A visitor told us that hot food is put in the hot trolley from 11.30 am onwards at weekends but not dished up until 1pm and as a result the food is often inedible. Some visitors go out and get fish and chips and send the meal provided by the home back.
We spoke to one relative that told us that when a change in medication had been recommended by a medical professional it had taken the home almost 3 weeks to obtain the new medication. During this time the person's well being had deteriorated.
People in Derwent told us that staff help them to change their clothes when they want to.
On our first day visit the home was very hot, particularly downstairs in Rydal. Nearly all the windows were open and nearly all the bedroom doors were propped open. Some people told us that they were too hot. One person said that they couldn't breath. They told us that they had asked for the heating to be turned down but been told by staff that, 'it has to be that hot'. The heating had been turned down to a more comfortable temperature on our second visit.
One person living at the home told us, 'staff are very friendly' and believed that they were well looked after. Another person told us, 'the girls are very nice'.
One person told us that staff, 'come in and out but don't have time to stop and talk'. Another person said that staff came in answer to the buzzer 'when they can, but they are very busy'.
Some people in Derwent told us that they were satisfied with the care they received. They also told us that their views were not sought by the home in relation to care planning, food or activities. None of the people spoken to knew what a care plan was and none could recall being asked by staff about what they thought of the care they received.
None of the people spoken to were aware of where the complaints policy was kept or what it said. Some people said that if they had any problems they would tell a member of staff that they liked so they could sort it out for them. We did not see a complaints leaflet on display in Rydal or Derwent.
One relative told us that they had complained that their relative was in pain but had been told by a senior manager that this wasn't possible as people with dementia didn't feel physical pain.
Some relatives told us that they didn't want to complain because this was the only home in the area that provided dementia care and they were afraid that their relatives would be asked to leave.