Dewar Close

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 75 (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 treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans reflected people’s choices, likes, dislikes and preferred routines. Care plans were regularly reviewed to ensure they continued to reflect people’s preferences and their physical, emotional and social needs.

People told us the care they received met their needs. Comments included: “They cover my support needs, but luckily I don’t need much”, “They look after me very well”, “I’m happy with the staff responses” and “As far as I am concerned, they know what’s needed.”

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 registered manager described the importance of supporting continuity of care both within the home and when people moved to other services. They explained, “The residents feel comfortable and know who is looking after them and they can build a relationship, and information does not get lost about them. It also gives reassurance to the families as well about who is looking after their relative." They told us when people needed to move to a different healthcare setting, they signposted relatives to partner organisations to support the transition. The provider’s director of quality and compliance explained this extended to any potential placements at Dewar Close and commented, “Our trusted assessors are employed by us but will signpost to other homes in the area if we havent got the specialist needs to support a person.”

Staff described the benefits of having continuity of external health professionals visiting the home who had time to get to know people well. A visiting healthcare professional told us, "We have a GP virtual ward round once a week and if we notice some people during our routine visits, then I will ask for them to go onto the ward round to discuss.”

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

Where people had identified communication and cognition difficulties, they had a communication plan which provided staff with clear guidance to follow. We saw staff following this guidance during our inspection.

Staff shared examples of how they had considered people’s individual communication needs. One staff member said, “We have different communication levels for people living at the home. Some people are hard of hearing, or their vision or speech may be impacted.” This staff member described how 1 person had a medical condition which affected their speech and said, “They just need time to find their words, so that’s what we do. We allow them time to tell us.” Another staff member told us learning was shared to support communication and gave an example of a person who had communicated their needs using Makaton. Makaton is a language programme that uses signs, symbols and speech to help people with communication difficulties communicate more effectively. The staff member said, “We did some training online to help us communicate with them.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider and registered manager recognised the importance of feedback from people and their relatives to help identify areas of good practice and when improvements were required. There were regular meetings which people and their relatives were invited to. During the meetings people were reminded of how to raise concerns and their opinions were sought.The registered manager explained, “What I don’t know about, I can’t put right.”

A member of care staff described the importance of listening to people’s relatives to ensure people received the right support. They told us, “If anybody knows a person better than themselves, then it is their family and friends. It is important to keep families involved because if something is wrong, then they may have an idea what is causing the problem. The residents might respond better to them as well."

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

Healthcare professionals visited the home regularly which meant people were able to access care, treatment and support when they needed to. This included the GP who visited weekly and district nurses who visited every day. Staff monitored people’s vital signs such as their temperature and blood pressure so they could identify any changes in people’s health which required external healthcare support. Staff also told us they knew people well which meant they could spot subtle changes which might indicate a deterioration in people’s physical, mental or emotional wellbeing. One staff member gave an example of a person who was not drinking as well as normal and told us, “There is a resident, in their normal self they are always jolly and having drinks. But the last couple of days they have not been drinking them. They have seen the doctor on the ward round today, just because of that little flag.” A senior staff member explained, “All the carers have been here quite a long time and know the residents well so we will act on staffs’ comments." Care plans informed staff what signs could indicate a deterioration in health associated with specific health conditions, such as diabetes.

The provider had considered reasonable adjustments to the premises to ensure accessibility for everyone. This included a lift, accessible community areas and gardens and adapted toilets and bathrooms.

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.

The registered manager recognised the inequalities and poor outcomes people could face due to their diagnosis or health conditions. They felt confident to challenge inequalities and find solutions to ensure people achieved positive outcomes. They gave an example of how they had supported a person with dementia to have a medical procedure and commented, “We were all doing as much as we could for them, but it felt like a battle to get 1 x-ray." The registered manager gave another example of staff advocating for a person to ensure they received appropriate support and medication as their health deteriorated.

Where a need was identified, staff supported people to engage with an advocate to speak on their behalf and help them make informed decisions about their care.

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.

Where people were nearing the end of life, staff worked in partnership with other health and social care professionals to make sure the person’s needs were met with dignity and respect. This included pain management and emotional support.

Care plans contained some information about people’s religious, cultural or personal wishes for their end-of-life care. This information ensured people spent their final days as they wished to. A regular professional visitor to the home told us, “I have witnessed the care of the staff as they sit beside a dying resident showing compassion. This continues as some of the staff will always attend a funeral of a resident.”