Sherbutt House

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 outstanding. At this assessment the rating has changed to good.

This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 made sure people were at the centre of their care and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Each person had a detailed care plan which provided staff with information about how to meet people’s needs and preferences. These were regularly reviewed and updated, including when people’s needs changed. Overall care plans were of a good standard. Where we identified some aspects which required additional detail or clarity, the provider was quick to respond to our feedback and add more information.

Daily records generally showed that care was delivered in line with people’s care plans, although there was some variation in the level of detail recorded in people’s daily care notes. There were also gaps in one person’s repositioning records, so it was not possible to clarify the support provided. The provider addressed this promptly.

Despite these minor recording anomalies, staff knew people’s preferences well and we observed staff were very responsive to people’s needs and wishes. Staff put people’s views at the heart of decision making and tailored the support they offered to people. People had a good quality of life and their package of care was individually tailored to them.

A relative told us, “It's the personalisation of care that really stands out. It's directly tailored to each person's needs.” An external professional told us, “Yes they do respond well to individual needs and have made adjustments quickly when needed to make my service user’s care more bespoke and person centred, which has resulted in them settling in well.”

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

The provider worked closely with the local authority and health partners to make sure people’s holistic needs were met, and to ensure people had smooth arrangements when accessing different services. People had good access to the GP and other health specialists where needed. People had received annual health checks and medicines reviews, where appropriate. Staff also ensured there was good communication with the other services and activities people accessed, such as day services, to ensure there was continuity of care and relevant information sharing.

If anyone needed to attend hospital, the provider had effective arrangements to ensure that relevant medical and care information was shared, supporting with continuity. The registered manager told us they usually also provided care staff to accompany people in hospital, to provide consistency and reassurance. One relative told us how beneficial this had been to their loved one.

The provider supplied appropriate, accurate and up-to-date information in formats that were suitable for people’s needs.

The service was meeting the requirements of the Accessible Information Standard (AIS). This standard requires providers to identify, record, flagging, share and meet the information and communication needs of people with a disability or sensory loss.Staff received induction training and refreshers in relation to the AIS, and the provider had a communication policy. People’s care plans contained information about their communication needs, and staff shared relevant information with health partners where required. Staff were skilled at understanding people’s varied means of communication and took these needs into account when interacting with people and presenting information. One person was supported to use picture cards at certain key times, and another person used a tablet with communication software to communicate with staff. Some people also used some Makaton signs and additional staff training was planned to refresh skills in this area.

Some materials, such as meeting minutes and information leaflets, were available to people in easy read or pictorial formats. The registered manager confirmed they presented information in a range of different ways according to individual needs, and they adapted the format of information however each person needed it. They also involved speech and language therapists where relevant.

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.

People and their relatives had extensive opportunities to provide feedback. The provider sent regular satisfaction surveys to seek feedback on a range of topics. The provider completed a thorough analysis and reflected carefully on any feedback to identify learning opportunities. There were regular meetings and people got feedback on any meeting discussions, survey feedback and action taken in response.

The registered manager confirmed they had received no formal complaints during the past year. However, they had a complaints procedure available, and people knew how to raise any concerns. People and relatives consistently told us they would feel comfortable raising any issues and were very confident issues would be taken seriously and resolved. They told us, “They are approachable and I could ring with any concerns” and “They'd sort it out for you - I'm confident of that.”

Relatives felt very involved and their views were used to drive change and improvements. One relative commented, “We are involved in annual reviews, and they'd ring in between times if we need to meet or discuss anything… We can have a really open discussion - about what I think, what [other relatives] think and what they (staff) think - and discuss what the issue might be.” Relatives also had access to an app that enabled them to review care delivery records, with people’s consent. Relatives told us they found this useful and reassuring. It also enabled them to feel more involved and able to make suggestions for the benefit of people.

We found that when any minor issues had been raised, including issues raised by staff, the registered manager completed very thorough enquiries and used the information as an opportunity to proactively explore any other changes required. In one instance, the registered manager’s investigation resulted in some unexpected learning about one person’s care needs, which the provider was able to use to effect a positive change to their personal care provision. The changes also made it easier for staff to care for that person. People were thanked for raising any feedback and given an explanation of the outcome.

The provider was exceptional at ensuring people could access the care, support andtreatment they needed when they needed it.

The provider recorded information about each person’s mobility, sensory and communication needs in their care plan, to support equitable access and promote inclusion. They ensured any potential barriers to inclusion were considered and addressed. For instance, the provider had advocated for accessible access to a local shop to make it easier for people. This led to the shop getting a ramp for disabled customers. They had also advocated to ensure one person had access a medical procedure, which resulted in a positive outcome for that person.

Staff supported people to access the services they needed. This included offering practical assistance and emotional reassurance to help people attend appointments, where required. They sometimes used social stories to help people understand and prepare for an activity or appointment. This helped to uphold people’s human rights by recognising and responding to individual access needs.

Staff and leaders listened to information about people who are most likely to experience inequality in experience or outcomes and tried to tailor people’s care in response to this.

Staff demonstrated a clear understanding of each person’s individual needs and circumstances, including awareness of any protected characteristics under the Equality Act. This helped ensure that support was tailored and responsive, reducing barriers and promoting equitable outcomes for people using the service. People were supported to practice their faith, where applicable, including attending the church of their choice.

The provider had equality, diversity and inclusions policies, which had been reviewed in line with relevant legislation. The provider’s training plan for the year included new training for staff relating to Equality, Diversity Human Rights. Audits and observations conducted by the management team monitored staff knowledge and practice in this area, including how well protected characteristics were reflected in care plans and supported in practice. This all helped promote equity in experiences and outcomes.
 

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were able to record any preferences they had about the final stages of their lives, within their care plans. At the time of our assessment, no one using the service was receiving support with end of life care. The provider confirmed they would work in partnership with relevant health and palliative care professionals if such support became necessary, to ensure care remained coordinated, respectful and responsive to people’s wishes.

The registered manager told us how they had previously supported someone with end-of-life care. They explained how the team had used the ‘About Me’ video care plan they had previously developed with the person, and how useful this had been in ensuring all the team were able to remember and focus on the person’s wishes and provide compassionate care.