Cholwell House Nursing 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 remained 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.

People and their relatives were involved in care planning and relatives confirmed they were informed when things change.

Most people’s care plans we looked at were detailed and informed staff of people’s choices and preferences about how they wanted to be supported. Plans for some health conditions such as diabetes were clear and described the signs and symptoms of high and low blood sugar, and the steps staff should take to rectify this. However, some people’s care plans lacked details about how their needs were met in some areas, for example, although hand contractures were referred to in a person’s care plan, there was no guidance for staff on any specific care needs the person required, such as how to care for the person’s nails.

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.Staff told us how they referred people for GP review each week. Staff could contact the GP surgery at any time if they had any concerns or questions, alongside weekly visits. We saw records in place of when people were reviewed by health professionals. A visiting health professional said, “The staff here have a lot of clinical common sense. I am confident that people here are safe.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were assessed, and the care plans we looked at provided staff with information on how to ensure people could communicate their needs and how staff should communicate with them. For example, in one care plan we reviewed, the person was hard of hearing, but preferred not to wear hearing aids, and had poor eyesight. The plan informed staff the person could read a wipe-board or white paper if staff wrote on it for the person. One staff member told us they were just on their way to ask the person a question about something, using the wipe-board method. Leaders said they have introduced dementia friendly clocks to help people understand what time of the day it is and reduce distress. The services provide a newsletter using large text and bright pictures to help people see the information.

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. Peoples concerns and complaints were recorded and responded to.Relatives we spoke with were confident their concerns would be listened to and dealt with. Leaders said they facilitated residents and family meetings where residents and relatives could share feedback and ideas about the service.

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

The service was easily accessible for those with mobility difficulties and who used specialised equipment to move around independently. Relatives confirmed equipment was in place to support their relative’s mobility. There was an on-call system covered by the senior management team to ensure out-of-hours support was available.

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.

Leaders said the service had arranged with a local minibus service to provide people with access to trips, so people had opportunities to go out to a local garden centre or lake. Leaders told us about a recent vintage motorbike festival which was held in the grounds of the service to raise money for the garden. One resident we spoke with spoke positively about this event. Relatives said activities took place in the service. Where some people were not able to get involved with group activities, relatives confirmed they were supported individually by staff with an activity they enjoyed. During our onsite visit, we saw members of the local church had come into the service to sing with people who wished to participate. We observed an area of the service which had a ‘memory lane’ of shops, for example, a butcher and a fruit and vegetable shop to support reminiscence activities and reduce distress for people. Leaders said staff support people in this area during the late afternoon and evenings because this is the time of the day when individuals with dementia can become more distressed. Leaders said the area helps people refocus and reduce feelings of distress.

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 had advanced care plans in place. Plans we looked at were detailed and described people’s choices for their end-of-life care. Recommended Summary Plans for emergency care and treatment (ReSPECT) forms were in place. These described personalised recommendations for a person’s care if they become acutely unwell. Staff told us they attended end of life training provided by the local hospice.