Appletrees Care 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 inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes. Care plans were being transferred onto a digital system, we reviewed both paper and digital documentation. Care plans had been reviewed regularly, however some lacked detail about people’s specific needs and preferences. Additionally, some care plans had incorrect information which related to other people living at the home, so we could not be assured people were always receiving person centred care. However, most people and relatives told us they felt the care provided met their needs. One person told us, “I like living in the home. It is always a pleasure. My room is nice and clean and it’s warm enough. The staff are very nice and pleasant. They leave me alone when I want to be left alone. Another person said, “They wash me in my bed. I just have a bed bath. It’s my choice. I just prefer to be washed that way”. Relatives described how they had enjoyed celebrating Mother’s Day by having a meal at the home with their loved ones. One relative told us, “There was a Mother’s Day lunch last month, invitations were given, we were given a table for two with flowers and tablecloth. Nothing is too much trouble. Staff are friendly and welcoming”.

The provider understood the diverse health and care needs of people, so care was joined-up, flexible and supported choice and continuity. External healthcare professionals were involved in advising, supporting and training on the care people received. There were regular healthcare professionals which visited the home, these included GP’s, nurses and a dietician, although some people attended appointments with their family as this suited their specific needs.

The provider supplied appropriate information in formats that were tailored to individual needs. Care plans held information of the best way to communicate and provide information to people. The registered manager described how staff provided support to people with a variety of communication needs, some of these included using simple words, or using prompts and gauging people’s body language and reactions for their responses. We saw there were pictures used alongside language to support people to understand different pieces of information such as menus and signage for toilets and bathrooms.

The provider had was a complaints policy in place. Staff recorded complaints and concerns received and documented actions taken in response to these. However, not all complaints had been handled in a supportive, caring and sympathetic approach. We were unable to ascertain any feedback from the provider in relation to relative and staff surveys. The area manager told us these had recently been sent back, and the information had not yet been collated. We did not receive any previous survey result information. The registered manager completed a “You said we did” board, people had made suggestions and some of the suggestions had been actioned. For example, people had asked for a church choir to come into the home, the registered manager had contacted the relevant person and were waiting for a visit date to be confirmed.

The provider engaged with a number of different health and social care professionals. Managers and staff told us they would support people to access care, support and treatment when people needed it. This was evidenced in people’s care plans. Referrals were made to other external professionals when required, for example the Mental health team, physiotherapists, Occupational Therapists and GPs. One healthcare professional told us, “There was a GP referral flagged by the service for a person whose mobility had declined and required a review”. They told us they gave verbal feedback to the service about the action plan and where the person was to be assisted with the use of a Zimmer frame for them to gain confidence in walking again. This demonstrated when people’s needs changed the service was proactive in seeking support by referring people to appropriate services.

Staff and leaders recorded information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. One staff member told us, “It is about treating people as an equal but treating them differently in a person-centred approach looking at culture, religion, upbringing, understanding their history particularly people with dementia, knowing likes and dislikes”. Staff had undertaken training to ensure they understood how to treat people equitably, the provider also had a policy in place.

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. However, these lacked detail about people’s specific funeral and end of life care choices. There were systems in place to record people’s advanced wishes. These included people’s choices regarding resuscitation in the event of requiring emergency treatment.