Hendra House Residential 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 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.

Care and support were delivered in a highly personalised and responsive manner, with a clear focus on people’s individual preferences, routines, and values. People were actively involved in decisions about their care and consistently encouraged to maintain independence. Each person was allocated a keyworker who liaised closely with them and their family. Keyworkers were matched to people’s preferences. For example, gender preference. A member of staff told us, “We are keyworkers which works great and we’re matched well. For example, if someone doesn’t sleep well their keyworker is usually a night worker.” A relative told us, “[Relative’s] keyworker keeps me up to date with everything. They are wonderful and we recently had a meeting to explain certain health changes and they talked me though everything. They even printed off the medicines my [relative] was on as some had been changed by the GP. We also agreed a plan of care. I feel fully involved which is so reassuring.” Staff demonstrated a strong and detailed understanding of what mattered to people, enabling support to be delivered in a way that was both meaningful and respectful. A relative told us, “They [staff] have a great care attitude and know [relative] very well and they are so good at tailoring care to meet their needs as they want. They are so supportive and flexible. They really listen and take everything on board. [Care manager] worked really well with us on finding the right room to suit [relative’s] preferences even finding a room with low lighting and good proximity. I can’t thank them enough for how much they helped us.”

There were several examples where staff had gone above and beyond to ensure people’s wishes were met. One example was where a person wanted to spend Christmas with their family 40 miles away from the home. This was facilitated by the care manager and deputy care manager who, in their own time, drove to collect the person on Christmas Day evening. Another person wanted to attend their relative’s wedding in South Wales but had no way of getting there so the care manager took them and they were able to enjoy the ceremony and reception before returning home the same evening. An act which was still appreciated by the person’s family.

People’s care plans were highly personalised and focused on what was important and mattered to them. Each person had a ‘This is me’ profile which provided staff with information about people’s life history, hobbies and the important people in their lives. This helped staff to form meaningful conversations with people and to really understand more about the people they supported. Staff had received training in person centred care and embraced the provider’s ethos of ‘no decision about me is made without me.’ A recent review of the home by commissioners found, ‘A well-established and resident-focused home with a strong emphasis on staff support, person centred care and continuous improvement.’ A healthcare professional told us, “Staff are approachable and receptive to suggestions regarding resident care and management. I feel there is a genuine effort to support residents as individuals, taking into account their medical needs, advanced care plans, personal preferences and the views of relatives where appropriate. Recommendations are listened to carefully and there is good engagement in discussions around care planning, symptom management and escalation decisions. Staff are willing to adapt approaches where needed and appear committed to continuous improvement.”

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

Care provision within the service was highly responsive, coordinated, and consistently centred around people’s individual needs, preferences, and changing circumstances. People consistently received personalised care that was regularly reviewed and adapted to ensure it remained relevant and effective. People and their relatives felt fully involved and informed about their care. A relative told us, “Communications are excellent and I feel fully informed and involved in all aspects of [relative’s] care.”

There was a strong emphasis on continuity, with staff demonstrating an excellent understanding of the people they supported. Most of the staff had worked at the home for many years; staff turnover was very low and there was no use of agency staff. This consistency enabled staff to anticipate needs, recognise subtle changes, and respond promptly and appropriately. People and their relatives told us they valued the continuity of care, which contributed to a strong sense of trust, reassurance, and stability. A person told us, “It’s excellent here, very good indeed. I don’t have to worry about anything. They [staff] treat us well and they’re so patient and friendly.” A relative said, “The staff are consistent and approachable. They listen, they are kind and nothing is too much trouble. I have nothing negative to say.”

The service worked proactively in partnership with a wide range of external professionals and agencies to ensure people experienced seamless care. This included effective communication and collaboration with healthcare providers, which supported timely interventions and positive outcomes. A healthcare professional said, “I receive regular updates regarding residents’ progress, well-being and any emerging concerns. On a weekly basis these are discussed during ward rounds, however if issues arise outside of this timeframe the staff communicate promptly either via the duty list, email or telephone. I have found the team to be appropriately vigilant in recognising deterioration, behavioural changes, safeguarding concerns or new medical issues. Communication is timely and allows for early intervention where required. Staff appear comfortable escalating concerns and seeking medical input when needed.” Transitions between services, including admissions and hospital discharges, were well managed, with clear planning and information sharing to minimise disruption and ensure people’s needs continued to be met.

Staff were responsive to feedback and changing needs, demonstrating flexibility in how care was delivered. Effective handovers and communication systems helped to ensure continuity of care across shifts. Staff told us communications were very good and they were always informed of any changes to people’s health or well-being. Overall, the service demonstrated a highly responsive approach to care provision, with strong systems and a positive culture ensuring continuity, effective integration, and consistently high-quality outcomes for people.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communications needs were assessed before they moved to the home and were clearly set out in a care plan which was regularly reviewed. Staff knew people very well and understood how best to communicate with them. We observed staff took time to explain information and checked people’s understanding. People received clear and accessible information about their care and support. Information about the service, including how to raise concerns or make a complaint, was provided in formats that met people’s needs. Examples included, using picture formats or large print where required. The provider told us people could expect information to be tailored to their individual needs which included the use of interpreters, sign language and audio formats where required. The home provided an electronic blog and brochure which also had an audio option for the visually impaired. The care manager had arranged secure video calls for people thinking about using the service and their relatives to show them what the home had to offer and to enable them to make a more informed decision.

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 were placed at the centre of decision-making, and staff consistently demonstrated a strong commitment to listening to and acting on what people said. A member of staff said, “We always aim to do better to make residents happy. This is their home and their happiness is our priority. Seeing residents smiling and happy means we are doing our job.” Peoples feedback was actively sought in a variety of ways and used creatively to drive continuous improvement. For example, staff regularly reviewed feedback and worked in partnership with people to develop and refine services. A local GP visited the home each week and 1 person had requested to see a different GP. This was facilitated by staff who now took the person to appointments at their preferred GP surgery. Regular reviews of people’s care plans were held with them and their relatives or advocates. Advocates are independent professionals who support people in expressing their views, understand their rights and make decisions. These were structured and ensured conversations covered all aspects of people’s care, activities, personalisation of their bedrooms as well as inviting people and their relatives to suggest anything that could be done differently. They presented opportunities for meaningful engagement and helped to ensure people continued to receive person-centred care. A relative told us, “Communication is excellent. We have regular reviews where our views are valued. I cannot fault them.” People and their loved ones also had regular one to one meetings with their keyworker. A relative said, “The residents have keyworkers which works very well, they send us photographs and communicate with us very regularly”. There were regular meetings and satisfaction surveys for people and their relatives which provided further opportunities for feedback or suggestions.

People told us they felt truly heard and valued, and that their input resulted in meaningful changes to their care and daily lives. For example, based on comments from people in a residents meeting, the main meal was now served at teatime rather than lunchtime even though this meant recruiting a new cook who was receptive to the changes. People had also been involved in the redesign of the garden. They worked with a garden planner to incorporate their ideas and suggestions, and this included a memorial garden where people could sit quietly and reflect. People had been involved in the recruitment of staff. The provider said this was very beneficial as, “Their opinions really matter.” Relatives and professionals described an open and inclusive culture, where communication was encouraged and acted upon. This approach fostered strong relationships and ensured people remained fully involved in decisions, even during periods of change or uncertainty. A professional said, “I have found the team approachable, professional and receptive to collaborative working. Overall, I feel there is a strong emphasis on providing compassionate, person-centred care while maintaining good standards of communication and professionalism.” A relative told us, “The staff are consistent and approachable. They listen and act and nothing is too much trouble.”

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

Staff ensured people had access to health and social care professionals when needed. One person said, “The doctor visits every week, and the staff will let them know if I need to be seen.” A relative told us, “They [staff] won’t hesitate in calling the doctor if they have any concerns and they will always let me know.” Staff understood people’s mobility, sensory and communication needs and used reasonable adjustments to remove barriers. For example, ensuring mobility aids were available for those people who needed them. Staff ensured people had access to hearing aids and spectacles where required. The provider kept the environment safe, accessible and easy to move around.

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

People were treated with respect and their rights respected and upheld. A relative told us, “They [staff] can be relied upon and are very proactive. They’ll highlight what’s needed and what they do shows they really care.” Staff had received training in equality and diversity and understood the importance of treating people as individuals. Care plans focused on what mattered to each person, including maintaining independence, managing health conditions, and feeling safe and supported. People’s goals were recorded in their care plans and outcomes were monitored through regular reviews and communication with people and their representatives.

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.

The service had received overwhelmingly positive feedback from the relatives of people who had passed away at the home. Comments included, ‘They [staff] were professional from the start to the end of life. We can’t say enough thanks for the help, kindness and support the lovely team of staff showed my [relative]. Until [relative’s] last breath, they cared for them and they were made to feel like family, and we had all our worries taken away. Many, many thanks for such a caring and loving place.’ And, ‘The fact that [relative] could stay at Hendra House right until the end meant an enormous amount to us. We were able to say our goodbyes in a peaceful and loving environment.’

The service demonstrated an exceptional, proactive approach to planning for people’s future, ensuring care and support consistently reflected people’s values, priorities and aspirations throughout their lives. Future planning was embedded early and revisited often, with sensitive, open conversations that empowered people to make informed choices. The service went beyond basic care planning, supporting people to consider a wide range of future scenarios, including changes in health, decision‑making ability, relationships and end‑of‑life wishes. We were given several examples where staff had gone above and beyond to ensure people’s wishes were respected. The registered manager and care manager made arrangements and facilitated 1 person’s wish to travel to Canada to see their [relative]. The care manager drove them to the airport and ensured all necessary arrangements were made to ensure the person was cared for on the flight and when they arrived at their destination. The same arrangements were made for their return to the UK. The person passed away at the home 3 months later having achieved their wishes even though they were nearing the end of their life. Another person, who had always enjoyed Christmas, was not expected to live long enough to enjoy it so staff decorated their bedroom and provided them with Christmas lunch and presents to ensure they had the Christmas experience they had always enjoyed and wished for. The person passed away 3 days later. Staff knew people well and there was attention to detail to ensure, for example, people’s favourite music was played for them, that the ‘garden was bought to their bedroom’ by bringing in flowers and plants from the garden and that their bed was positioned so they could see out of the window.

Care plans contained important information for staff to ensure people’s wishes and preferences were respected. Care plans showed how people were supported in line with any advance decisions they had been involved in, such as those made in their ‘Recommended Summary for Emergency Care and Treatment’ (ReSPECT) forms and ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions. ReSPECT forms are a personalised document containing recommendations for a person’s clinical care in a future emergency if they are not able to make decisions or express their wishes at that time. They include whether, along with DNACPR forms, in the event such as if a person’s heart stops or they stop breathing, they would want Cardiopulmonary Resuscitation (CPR) to be completed or not. Having people’s wishes clearly known for their future care helped to ensure their rights were upheld.

 Staff had received training about supporting people during their final days and following death. The care manager had obtained a level 5 Management of End-of-Life diploma and was the only non-registered nurse to achieve this award. This member of staff undertook the ‘Champion’ role in this area. This included, promoting best practice, supporting staff to recognise and respond to people’s changing needs, ensuring that people’s wishes and advance care plans were followed, coordinating with families and professionals for seamless care, providing training and offering support throughout the person’s care pathway.

The service worked with health professionals, including GPs and specialist palliative care services, to support co‑ordinated and responsive care. Medicines to help ensure people remained comfortable and received appropriate pain relief, should they commence on end-of-life care, were held in stock where it was anticipated people may need them at some future point. Having these needs anticipated and the relevant medicines available meant there was no delay in ensuring a person’s comfort should their health deteriorate. This helped support staff to be able to provide responsive care. Information was shared appropriately to help ensure people received consistent support and symptom management at home.

Managers and staff demonstrated respect and compassion even after people had left the care of the home for the final time. A representative from the home always attended the funeral of a person who had passed away, and the registered manager/provider and the care manager had been asked on numerous occasions, to deliver a eulogy at the service.