The Larches - Tiverton

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 remained Good.

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

This service scored 71 (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 were reflective of the person-centred care we observed. People’s individual requests were seen to be acted on. A relative told us, “Very much happy with the care and staff keep us informed with everything, I think all [relative’s] needs are met.”

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 senior staff and managers had effective systems in place to identify when someone became at risk of malnutrition and timely actions were taken to put measures in place to support the person, for example, liaising with the GP and pharmacy to have nutritional supplement drinks prescribed. Evidence of timely escalation of concerns was noted several times.

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

Relatives told us they were kept informed about people’s appointments and what was going on in the service. A relative told us, “They ring me, tell me exactly what's happening.” Information about people in the service was kept securely via electronic records which staff could access readily. Staff understood people’s communication methods and styles and provided information in ways which met people’s differing communication needs. For example, staff knew who had hearing aids, who liked to spend time in their room and who preferred to socialise in the lounge. We were not able to find the CQC ratings displayed, and the manager told us the ratings are usually kept in a folder at the front door. This was missing during our on-site inspection; however, the manager assured us they would print off a new copy.

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.

Relatives told us they were given regular updates about their relatives. A relative told us, “They do have to try hard to get [relative] to eat and drink as their appetite goes and they have specific nutritional needs, and they try to do variations. If [relative] doesn’t drink, they get urinary tract infections (UTI’s) so staff do give them drinks all the time.” There were relative meetings and meeting minutes were emailed to families who could not attend. There was an electronic feedback system at the front of the service which prompted people signing in and out to give feedback on their visit and this was monitored regularly by the manager so they could address any negative feedback.

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

Managers worked closely with partner agencies such as the local GP surgery and nursing team to identify people who were at risk of deterioration and swiftly implemented protocols which improved their quality of life and focussed on their health. The led to people being able to access the right medical intervention at the right time. There was an on-call system covered by the senior carers and management team to ensure out of hours support was available.

People were treated equally, and their care and treatment was adapted to meet their individual needs. Staff had received relevant training and had a good understanding of people’s rights, discrimination and inequalities and what to do to protect people’s rights. However, not all staff we spoke to were able to explain what DoLS were, or what restrictive practice meant for people living at the service. We spoke to 8 staff members and of all the staff we spoke to, no one was confident in their understanding of DoLS. One staff member told us, “There’s no one under a DoLS that I know of, and I don't know what that is.” Another staff member told us, “We get informed who is vulnerable and can't go out alone, but most people don't go out. I don't think it comes into practice. I think everyone has DoLS.” We addressed this inconsistency with the manager who then organised additional DoLS training for staff.

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’s wishes for their end-of-life care had been discussed and noted. Staff had received specialised training to support people with their end-of-life care. The service worked with the local community nurses in supporting end of life care. A person told us, “When people have died whom we have made friends with, they let us say goodbye to them. It's very kind, they let us say a prayer for them. They tell us sensibly when someone has passed away.” During our inspection we witnessed end of life care for someone and observed staff acting in a person-centred way in line with the person’s wishes.