St Cyril's Neurological Care and Rehabilitation Service

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

Care plans were not person centred and were often task based. Information about people’s preferences for example; personal hygiene; sleeping; diet were not always documented. Some people had needs for which there was no care plan in place at all. This meant staff lacked any adequate information to enable them to deliver person centred care that met people’s individual needs and preferences. Information about some people’s some communication needs was contradictory, which increased the risk of them not receiving the right support to be able to express their views and feelings. Staff awareness and understanding of people’s communication needs was poor and the specified communication aids that some people needed were not in use. This must have been very frustrating for people who due to their acquired brain injury struggled to communicate verbally. These shortfalls were a breach of Regulation 9, Person Centred Care. Most people told us they felt listened to and some said they had been asked if they were happy with the support provided. However, no-one living in the home or their relatives had formally asked for their feedback or had the opportunity to attend a resident/relative meeting at the service to share their views and experiences.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found people did not always experience care that was person centred, as staff lacked sufficient information on people’s individual needs, wishes and preferences. People's monthly care reviews were not meaningful and did not demonstrate people were involved in regular discussions about their care and progress. This did not show people were at the centre of their own care.

Care plans required improvement in order to ensure staff had sufficient information on people's needs and wishes to enable them to provide person centred care.

The care provided was not always person centred as people did not always receive the right support for their needs. For example, some people required regular repositioning in support of their individual skin integrity needs, but this support was not always provided at the right times. One person had specific risks that required mitigating and episodes of distress yet the person's care plan was out of date and failed to provide staff with any clear guidance on how to support the person's emotional wellbeing in order to prevent harm. Records showed that this person's emotional distress continued. Another person required support to maintain good bowel health, yet their care plan contained no person centred information on the person's usual bowel habits or the continence aids required to maintain their dignity. One person was at increased risk of dislodging their tracheostomy tube and had a personalised schedule of hourly safety checks. We found however these checks were not completed hourly as required which meant the person's individual care regime had not been followed.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People’s communication needs were not adequately supported. The majority of information was presented in written format and where people had communication difficulties there was a lack of communication aids and systems used to help them communicate. Written information about people needs was not accurate or up to date. This meant if people or other professionals requested this information, their health and care records were not a true reflection of their needs.

Staff told us they had access to policies and procedures both paper based and online. Staff relied heavily on paper based systems to perform their job role.

People's personal information was collected and stored in line with data protection legislation. However there was little evidence in people's care files as to what information they had consented to share with other parties, such as other health professionals and family members. There some information about people's communication needs in their care file, but this information was often contradictory. The specified communication tools designed to help them access and understand information was not always in place. Provider audits had not identified or addressed this.

Most people told us they felt listened to and some said they had been asked if they were happy with the support provided. None had completed a survey or attended a resident/relative meeting. None of the people we spoke with had any concerns or complaints, but knew who to talk to if they did.

There was a complaints procedure and system in place for responding to complaints and concerns reported. We saw evidence of this. We asked about the mechanisms in place for people including staff to share feedback on the service received. They told us they were unable to find any recently completed surveys that obtained feedback on people's satisfaction with the support they received. They also said that no relatives/resident meetings took place to engage with people using the service and their relatives, but that they had plans to introduce this. Staff meetings took place to obtain staff views and opinions on the running of the service.

There was a complaint and compliments system in place to gather and respond to people's feedback. There were no other formal feedback processes in place to enable the management team or provider to seek and share people's feedback on the service in order to drive up continuous improvement.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.