Devonshire Dementia Care Home

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

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment, we rated this key question good. At this assessment, the rating has changed from good to outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The provider implemented an innovative hydration programme. Service users and relatives were involved to co-design specific hydration areas, including cafe, pub and hydration areas based on individual preferences. This resulted in service users drinking more fluids throughout the day as it was a familiar sociable place to meet, this subsequently reduced urinal tract infections (UTI) over a 12 month period. UTI’s are kidney infections commonly caused by poor hydration.

People were treated as individuals and they received consistently good, person-centred care from‑The provider delivered personcentred care that reflected people’s individual needs, preferences and histories. An example of this was having music chosen by the residents available on devices throughout the home, including a purpose in built sound system in the communal bathrooms to assist with relaxation during personal care/baths. Care plans were not generic and contained detailed information about a person’s unique strengths, personal interests, daily routines, likes and dislikes, and how they preferred staff to meet their assessed care needs and expressed wishes. Staff gave us an example of how they actively encouraged and supported a person who liked gardening to design and manage a small garden in the grounds of the care home, which they told us had significantly increased this individual’s confidence and overall sense of purpose.

People and relatives consistently described care as not only tailored, but genuinely life‑enhancing. Relatives frequently described staff as always being patient and taking their time to understand their family members wishes and thinking creatively about social activities that would be of interest and meaningful to them. For instance, we observed staff actively supporting someone to paint whose care plan clearly identified this was something they had enjoyed doing before they had moved into the care home.

A relative described how staff arranged regular outings to the park and to a garden centre, reflecting a strong commitment to supporting people’s preferred routines and personal interests. These experiences enriched people’s social lives maintained important community connections and promoted emotional wellbeing.

The care home continued to experience good staff retention which meant many of the managers and staff had worked there for a long time and were familiar with people’s needs, preferences and daily routines. Our observations supported this, and we saw staff using people’s preferred names, engaging them in conversation about topics they enjoyed and adapting support in response to individual cues.

The provider understood the diverse health and care needs of people and their local communities, and ensured care was joined-up, flexible and supported choice and continuity.

People told us staff understood their family members care needs and that they worked-well with multiple community-based health and social care professionals to consistently meet those needs. People received care and support from services that understood the diverse health and social care needs of their local communities.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Managers and staff demonstrated an initiative-taking approach to sharing information and seeking feedback, ensuring people living in the care home, relatives and community care professionals were all fully informed and meaningfully involved. Managers and staff were aware of their role and responsibilities to meet people’s communication needs and make information accessible. The provider had an Accessible Information Standard policy in place which was raguly reviewed. People’s communication needs were assessed.

The home had various ways of providing information to service users, including technology such as interactive screens and dementia radios. This enabled information to be provided in multiple formats to meet individual needs.

Managers and staff followed guidance in care plans to make sure they communicated with people in a person-centred way to enhance their understanding. Staff ensured information was shared with people in a way they understood. For instance, extra-large easy to understand pictorial signage was displayed throughout the care home to help people identify the function of different rooms, such as toilets, bathrooms and various communal areas. We observed staff use large-print materials and photographs to help people make an informed decisions about what meal they chose to eat for their lunch. We also saw a large board in a communal area which contained various images and symbols that represented people daily preferences and needs, was used by staff to enable people to make informed decisions about what social activities they might like to choose to participate in. In addition, the service users guide and complaints procedure were available in multiple accessible formats such as easy to read pictures, large-print materials and audio recordings.

A comprehensive range of initiatives was also used to capture views, including annual anonymised surveys for people, relatives, staff and professionals, digital feedback tools, website submissions, cards, letters and emails. Regular relatives’ meetings further strengthened communication and created accessible opportunities for open dialogue. Relatives consistently described communication with the provider as being consistently strong, with multiple channels used to keep them updated and informed. A relative said, “The night staff here are very good at keeping me informed about how my [family member] slept in the night which I appreciate.”

Information for people, visitors and professionals was shared appropriately, in line with data protection and accessible information standards.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

The home promoted a positive working culture. Shared learning was embedded and underpinned by the organisation's key values and ethos. People told us they felt comfortable raising any concerns they might have with the managers and staff and were confident their views would be taken seriously. A relative said, “I have never needed to make any complaints about this home, but I know how to and I am extremely confident the managers would take me seriously and address any issues I might have as quickly as they could.” Managers explained they addressed any concerns raised promptly. Records confirmed previous safeguarding concerns had been managed openly with those involved and resolved.

Staff and community-based health and social care professional surveys demonstrated positive experiences, reinforcing that information was shared in ways that built confidence and trust across all groups. We saw multiple easy to follow flowcharts for staff to refer to as an aid memoir were displayed throughout the care home. This ensured staff had access to up to date guidance about what steps they need to take to prevent or safely manage identified risks people might face including, risks associated with skin integrity, infectious diseases, falls, and behavioural incidents that required positive support from staff.

People and families participated in wider decisions about the care home. The provider used a range of methods to encourage people to have their say and state their views about the standard of care provided there. This included regular one-to-one sessions with their designated keyworker, care plan reviews and satisfaction surveys. Staff have seen positive affect on behaviour and participation from residents as a direct result of implementing relative participation. Relatives had the opportunity to attend regular meetings and felt listened to by the care homes management. Involvement extended to care planning and reviews.

The provider made sure that people could access the care and support they needed when they needed it.

People had equitable access to the service, and support was adapted to ensure their needs, preferences and circumstances were met. Adjustments were made to promote inclusion, safety and choice. People had sufficient opportunities to engage in meaningful leisure and recreational activities that reflected their social interests. The care home was well-resourced with various arts and craft materials, oversized playing cards and puzzles. Staff actively supported people to regularly attend various social activities in the wider community including, visiting local parks and garden centres. People and their families were supported to be involved in discussions about people’s social interests, which was recorded in their care plan.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care and support in response to this.

Managers and staff assessed and planned for people’s diverse needs. They made sure barriers to providing care were identified and mitigated. This ensured outcomes were positive, and people felt understood, safe and well supported. Staff respected people’s identity, personal routines and need for consistency. Staff undertook training to understand about equality and diversity. Staff knew how to protect people from discriminatory behaviours and practices.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

People experienced a comfortable and dignified death in the care home. The Gold Standard Framework awarded this provider ‘Platinum’ status in recognition of their compassionate and exemplary standard of care and support they provided people approaching the end of their life.

The service provided person-centred end of life care based on best practice. Care plans demonstrated a person‑centred approach to planning for the future, ensuring people’s wishes were clearly understood, recorded and met. People and their families were supported to be involved in discussions and participate in decisions about their end of life care wishes.

Relatives confirmed they were actively included in advanced care planning discussions.

People’s needs had been considered as part of their advanced end of life care plan which took account of peoples preferred way of communicating, ability to understand and capacity when decisions were made. Where appropriate, advanced care plans and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were clearly documented and flagged in peoples care plans.

The service enabled people to engage with their religious and spiritual beliefs. People’s preferences and choices for their end of life care and where they wished to die was clearly recorded in their care plan and acted upon. This included detailed information about people’s cultural and religious wishes and expectations when it came to dying and death for people who practised a particular Faith. The team ensured arrangements were in place for the relevant spiritual leaders to visit the care home as they were approaching the end of their life in line with their expressed wishes. This demonstrated sensitivity to both cultural and spiritual needs when planning for the future. The provider had clear and detailed advanced care plans for the service users. Staff also had additional training in how to identify when a person deteriorates enabling them to respond and refer to the correct service promptly.

The provider collaborated closely with community-based health and social care professionals and bodies to provide compassionate and comfortable end of life care. This included GPs, district and palliative care nurses and the local hospice. Managers told us they worked closely with these community care professionals and bodies to continually assess and manage people’s pain and other symptoms as they approached the end of their life. For example, they completed regular rounds and end‑of‑life and advanced care planning reviews with the GP when they visited the care home. In addition, the provider used shared digital systems to ensure future plans were visible across agencies so the person’s wishes and preferences in relation to end of life care were shared and respected. Community care professionals told us the service always sought their advice care and support for people approaching the end of their life and responded quickly to people’s changing care needs. A care professional commented, “Staff are confident in using equipment for residents on end of life care.” This ensured people had access to the right support and equipment they needed as they approached the end of their life.

Managers and staff had the knowledge, skills and experience to understand and meet the emotional and practical needs of people approaching the end of the person’s life and their families. Managers and staff had all received end of life care training. In addition, staff could seek advice and support from the services 3 end of life care champions who had all received additional end of life care training.

The services approach to supporting people’s families and staff after someone had died was empathetic and understanding. People were offered bereavement counselling and staff had received bereavement training. The service also had a dedicated memorial wall and a newsletter which contained the names, photographs and a social history of people who had died in the care home to help people remember and celebrate their lives.

Managers and staff worked-well with people they supported, their relatives and external care professionals to help plan goals and objectives for people living in the care home. Managers and staff told us they discussed future aspirations regularly with people such as what they would like to do in the future, and this included how they wanted to be independent and how that could be achieved.