Hydon Hill - Care Home with Nursing Physical Disabilities

People did not receive safe care in relation to medicine management. There were suitable numbers of staff who had been safely recruited to meet people’s basic care needs. However, staffing levels were based on staffing routines and shifts rather than providing person centred care. The principles of RSRCRC were not met as the model of care provided did not allow people to live empowered lives with maximum choice. Staff were aware of the individual risks to people and how to manage these.

People and their relatives were not always involved in assessments around their care, meaning their contributions could be missed. People’s rights were not always protected due to staff not understanding the principles of The Mental Capacity Act (2005). Records around mental capacity and best interest decisions were also lacking important information to ensure the least restrictive practices were used to deliver care. People, relatives and staff felt positive changes had been made to processes since the clinical lead had been in post. People received varied experiences in accessing specialist care to meet their health needs.

Although people told us staff were kind and caring towards them, people were at risk of receiving institutionalised practices. People received varied outcomes around choice and control of their care. This seemed particularly poor for people with a learning disability. This meant the service was not meeting the principles of RSRCRC as the model of care did not maximise people's choice, control and independence and the care was not person-centred .

Whilst care records were detailed around the physical care people required, there were gaps in the provision of supporting those with communication needs to have their opinions and choices heard. This therefore did not maximise the choices for people with a learning disability in line with RSRCRC guidance. Staff demonstrated poor understanding of how to deliver person centred care.

Processes in place as well as the ethos, values, and behaviours of leaders and care staff did not always ensure people using services lead confident, inclusive and empowered lives. Leaders showed a lack of understanding on how to meet the RSRCRC principles. Quality governance systems were not effective in their use. Staff felt confident in being able to speak up if necessary, and felt supported in their roles.