St Cyril's Neurological Care and Rehabilitation Service

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Most people told us, and we observed that staff were kind, caring and patient. Most people said staff were respectful and they were well looked after. Staff knew how to protect people’s privacy and dignity and were able to give examples of how they achieved this when providing personal care. However, the provider's mandatory training programme did not include privacy, dignity or equality and diversity training. Most people told us staff knew how they liked to be cared for. We saw care records contained some information about people’s wishes and preferences however this information was limited especially with regards to personal hygiene preferences and people’s communication needs. Care plans also contained contradictory information about people’s ability to be independent. People felt however that their ability to be independent was supported by staff. There was a range of activities for people to become involved with in the home and most people were supported to maintain relationships and networks that were important to them. Visiting to the service was however restricted to specific times which limited people's ability to visit.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people and relatives told us staff were kind, caring and respectful. Comments included, “Staff are very kind” and “The staff are so kind and funny. I am so grateful for them, they are really wonderful people. They know me well and are very respectful of me”. One person felt at times not all staff treated them with dignity and respect.

Staff described how they helped to ensure people were treated with dignity and respect when care was provided. This included, “Take consent, inform them what we are going to do, make them comfortable and cover them up”; and “Close all curtains, lights on, close door, do half a body at a time, sign on door ‘Do not disturb’.

Feedback from Commissioners included staff “Manage patient care (and relatives/carers) with dignity and respect, achieving good outcomes”.

We observed staff were kind, caring and patient when providing support to people.

Most people felt staff knew them well. Comments included, People comments included, "They are getting to know me and chat to me” and "They know them [Name of person] very well and they have a great relationship".

We asked staff how they learned about people's wishes and care preferences, they referred to the care folder located in people's bedrooms. These files contained an ‘All about Me’ document and basic information about people’s needs and preferences. We found that despite information about people's communication needs being specified in these folders, staff were not clear who required communication aids to support their day to day communication. Two staff members responsible for supporting a person who required a communication system to be used, told inspectors that the person did not need or have one in place. Another staff member told us ‘nobody’ used any communication system.

People's care plans contained limited information about their individual needs, wishes and preferences. This did not promote the delivery or a culture of person centred care that focused on meeting individual needs, wishes and preferences. For example, one person's wishes and preferences with regards to personal care, nutrition and hydration gave no guidance on their individual preferences with regards to washing and dressing, or eating and drinking. Other information in this person's care file about their needs, wishes and preferences was contradictory which hindered the ability and understanding of the staff team to provide tailored care and support. Some people's care plans designed to promote individuality referred to another person's name. It was unclear therefore if the care plan in the person's care file was specific to them. This did not demonstrate that people's care was planned in a way that supported their individual needs, aspirations, strengths, and wishes at all times.

The processes in place to ensure staff had the information they needed to provide tailored support to individuals was not robust. Care plan audits had not identified that people's care plans were not person centred or sufficiently detailed to enable staff to gain a full understanding of the person and how they wished to be cared for. There were no formal processes in place to seek feedback on people's satisfaction with the support they received in accordance with their wishes and preferences. These shortfalls were a breach of Regulation 9, Person Centred Care.

People told us they were given choices in how they lived their life in the home.

Staff told us people were able to chose when they got up, went to bed, what to eat and said they supported people's routines.

We observed staff chatting to people and giving them a choice.

Care plans contained some information on what people could do independently with regards to personal hygiene and mobility. There were processes in place to support people’s day to day choices and right to independence. For example one person was being actively supported for discharge back to independent living. Their support included help to regain daily living skills such as shopping, making meals and to access the community independently. People were encouraged to maintain and develop relationships with those close to them however there were restrictions on the times family and friends could visit, which may have impacted on the ability of people to see and enjoy the company of their loved ones. We discussed this with the management team.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.