Our response to the CQC report
CQC said: People were not always supported to take part in activities which were relevant to them, in particular people living with Dementia.
Our response: On the day of inspection our activities coordinator was on a rostered day off, however activities were happening on that day. We had a coffee morning that was attended by residents and more individual activities in the afternoon.
We have recruited another activities team member, and increased the opportunities to use our own and community resources with lots of evidence of meaningful activities enjoyed by our residents. We have made community links and there are plans to bring community groups in to our home. We also respect that some resident’s choice is not to want to take part in all activities that are offered, especially residents with capacity who will make an informed choice on the da
CQC said: We observed people left unsupported for extended periods of time which meant they engaged in self-soothing activities.
Our response: Two periods of time were observed by the CQC on the dementia unit being left unattended by staff, although all other units were observed to have been supported by staff. We have increased the number of staff on the dementia unit, and there is a constant presence. We have invested in suitable activity multi-sensory items to stimulate and involve this group of residents
CQC said: The decoration and furnishing of the dementia unit was not designed to support people living with Dementia, and the Allonsfield unit was tired and in need of improvement.
Our response: Our improvement plan had already highlighted areas of the home that needed redecorating. The front of the building is the original construction with beams and this is being renewed and updated, in keeping with the period. Doors and corridors have been redecorated.
The service does consider the decoration of people with a diagnosis of dementia with easy to read signs and an environment that is free to walk. We have a safe garden which at the time was being developed into a dementia garden with aviaries and has birds and raised beds painted in bold colours. Flowers have been chosen for sensory stimulation
CQC said: There were sufficient staff to meet people’s needs. However, they were not always deployed effectively.
Our response: The home has three units to deploy staff across and we do ensure we have staff in each unit to support residents. We have a care coordinator and senior staff that have the responsibility to ensure staff are deployed in the correct areas with the highest need. We discuss staff allocation at our daily meetings, and review staff deployment, according to skill mix and resident dependency, also taking in to consideration how the units are on the day.
CQC said: We observed everyone in dementia dining room given the same size portion of food.
Our response: A second helping of food is always offered at mealtimes. Dementia UK encourages smaller regular size meals to encourage eating. People were complimentary about the food and all dietary requirements were met and show plates were shown to all residents for a visual choice. All weights and nutrition are monitored and recorded. The chefs who serve food, are aware of individual appetite sizes and different size plates and bowls are available
CQC said: There were not always staff in dining rooms to support people if needed
Our response: One member of staff is routinely allocated to each dining room at meal times. In addition, there is a member of the kitchen team present in the dining room at mealtimes, to provide information, advice and support
CQC said: There were inconsistencies regarding checking of equipment
Our response: All roles are now aware of which team members have responsibilities for each piece of equipment
CQC said: There were no books magazines or dementia specific items
Our response: We have purchased multi-sensory items for all areas of the home, and appropriate to the type of resident cared for in that area. The items can be used by all members of the team, at any point during the day
CQC said: The potential of the farm to support people’s well-being was not realised
Our response: We are reviewing how the home and farm integrate, to ensure our residents get the maximum therapeutic benefit. We have also made community links, so other areas of the locality can enjoy its benefit
CQC said: No one was shown the menu or able to read it independently
Our response: Our hospitality manager is responsible for replacing and presenting the daily menus. Her role also encompasses setting the scene and atmosphere for mealtimes
CQC said: In the dementia unit (at mealtimes) people were waiting, and there was little supervision interaction for those waiting
Our response: We have reviewed our meal timings, looked at how long residents have to wait between courses, and changed the order of service for units
CQC said: The setup of the dining room made it difficult to distinguish between areas
Our response: We have reviewed the dining room experience, particularly in the dementia unit. Table linens, furniture and flooring, have been reviewed. Residents are now able to adequately distinguish, and the dining room is coordinated and dressed, with gentle background music to enhance their mealtime experience
CQC said: There were no condiments
Our response: Condiments are available for all during mealtimes. The staff member presence, ensures these are used appropriately and choices encouraged
CQC said: We observed some interactions which were perfunctory and task led.
Our response: We have worked hard to ensure that our care is person-centred and not task led. Senior members of the team, are positively modelling person-centred care, to support our care team. Integration to our new care plan system, in early 2024 will help make the move to more person-centred care
CQC said: It was not clear how the activities were recorded, and the activity log didn’t describe what activity took place
Our response: We are actively supporting the activity team to ensure all interactions are recorded positively. Again, our new care planning system will enable our activities to be more accurately recorded
CQC said: There was mixed feedback from relatives as to how well the service communicated with them
Our response: Relative meetings are held every month at our coffee morning. The families are emailed details of these meetings, minutes are taken, and will ensure these are sent out to all family members, whether they attended or not. Family members are also contacted to come and review their residents plan of care on a regular basis. There is also a keyworker in place who is the main contact for each resident
