Heartly Green

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 requires improvement. At this assessment the rating has remained the same. This meant people’s needs were not always met.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The manager tried to make sure people were at the centre of their care and treatment choices, but this was not always possible due to the resources available to them.

The manager and deputy manager were working to ensure electronic care plans contained person-centred information relevant to each individual. Some care plans contained detailed guidance for staff in how to meet people’s needs whilst others were basic and task focused. The provider was aware of shortfalls in this area and was reviewing people’s care with them and their relatives to improve care delivery.

It wasn’t always clear if people had been involved as this wasn’t recorded within electronic care plans. Some people were involved in planning their care as one person told us, “I believe my care plan gets updated and I do ask to read it, which they let me see. If I am ever unwell, they let my family know.”

Information about people’s life histories was to be sought to help further personalise people’s care; this was to be the role of the activity co-ordinator. We saw one good example of a person’s life history which had been provided by a relative.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Care information was not always current, complete or consistently reflected in practice. This reduced assurance that staff had access to accurate information about people's needs and support arrangements. As a result, people were at risk of receiving care that was not consistently delivered in line with their current needs and preferences.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

There were people of different nationalities living in the home and we identified several language barriers due to this. There was no evidence to indicate people had been supplied with information in accessible formats which were tailored to their individual needs; we were not assured people always received information in a way they could understand and use.

Where possible, the manager allocated care staff who spoke the same language, or understood the person’s first language, to aid good communication. Flash cards and translation technology were available for staff to use; the service could access professional interpreters for GP and mental-health appointments.

There were mechanisms in place for people to share feedback and ideas, for example via resident and relative meetings and surveys. However, it wasn’t always clear how or if actions taken had been shared with people. When staff involved people in decisions about their care it wasn’t clearly documented if people had been told about any changes that were warranted.

People we spoke with were comfortable in raising their concerns with managers. One person said, “I can speak for myself as my disability is physical, so I am very comfortable in speaking out if I need to.”

People were also able to raise complaints about their care, treatment and support, and we saw the manager had responded within designated timescales. The Resident of the Day approach was a new process and needed to be embedded into practice to be fully effective.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People who had higher support needs and required more that one member of staff were at risk of having less access to care and support when they needed it. There was limited support for people who needed this at mealtimes due to staffing arrangements. Some relatives chose to visit the home at mealtimes to help their loved ones to eat; this aligned with people's personal preferences and the home's open-door visiting policy.

For those people cared for in bed or who preferred to spend time in their rooms it wasn’t obvious if they had been told about activities or entertainment in communal areas.

People had access to healthcare professionals and specialist services when required. The provider worked with external agencies and healthcare professionals to support people's care and treatment needs. There were sometimes delays in external referral systems, but the manager could evidence these were managed and followed up by staff. People were supported to attend appointments and access healthcare services.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The provider did not always demonstrate how care and support had been adapted to meet people's individual needs and circumstances. We found examples where care planning, support arrangements and equipment usage was not fully reflected in people's assessed needs.

We also identified a person whose needs were not fully aligned with the service environment. This reduced assurance that barriers to positive experiences and outcomes had been identified and addressed, or that people were consistently supported to achieve outcomes that reflected their individual needs and circumstances.

People were not always 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.

End of life care plans lacked detailed information about how people wanted to be supported at the end of their life. They did not always reflect if discussions with people or their loved ones had taken place or describe how they were involved. The provider was aware of shortfalls in this area and was reviewing and updating care plans as part of the service improvement plan.