Albany House - Bognor Regis

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• 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 requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 62 (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 make sure people were at the centre of their care and treatment choices. There was not a holistic approach to providing person-centred care.

Some aspects of care were not person centred. People’s individual needs and preferences were not always assessed in line with current evidence-based guidance. Staff had not completed holistic functional assessments to determine people’s needs and abilities. There was a lack of individually designed programmes to support people to learn or regain skills to improve their independence and quality of life. For example, one person said they liked to go swimming. A staff member explained the person had been supported to go swimming, but this was not a regular activity. They told us the person had last gone “about a month ago.” There was no plan to support this activity regularly.

Care plans lacked personalised details about the impact of people’s mental health needs. For example, a person’s care plan included a diagnosis of bi-polar disorder but there was no detail about how this affected them, what signs or symptoms might indicate a deterioration in their health and how staff should support them in the way they preferred.

People told us they had enough to do and enjoyed some organised activities at the service. We observed some people taking part in activities, people were clearly engaged with artwork and appeared to be enjoying this. One person told us they enjoyed quizzes and games with the staff, another person said they liked it when staff arranged for animals to visit the home. They told us, “We are going to have a donkey visiting soon.” Some people were able to go out in the local community and told us they had a regular walking routine. Some people told us they were looking forward to a holiday planned for later in the year with other people and staff from the service.One person was being supported to visit family members abroad. The registered manager told us the person looked forward to this annual trip.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supportive of choice and continuity.

People and their relatives said staff supported their health and care needs in a flexible way. One person said, “They help me with appointments if I need it.” A relative told us how staff were proactive in supporting people’s mental health needs and contacted mental health teams if they were concerned about changes. They told us, “The relief for me is huge knowing (person’s name) is look after safely.”

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

People’s communication needs were identified and supported. One person’s ability to understand information had deteriorated and staff had recognised risks of isolation due to changes in their cognition. Their care plan included guidance for staff in giving verbal reassurance and answering questions on a daily basis, to support the person’s understanding about their daily routine. Another person had a set of picture cards to support communication needs. The registered manger was aware of the requirements of Accessible Information Standards. They gave an example of how communication needs were included within a person’s hospital passport to ensure health care partners had information about their individual communication needs.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Staff sought feedback from people about their care and support through individual meetings, joint meetings for people who lived at the service and with surveys. The views of people’s relatives and health and social care professionals were also sought. People told us they knew how to complain and were confident the registered manager would deal appropriately with any concerns they raised. One person told us about a previous concern saying, “I didn’t like the way they (staff member) spoke to people.” They explained how they had told a staff member about their concern, and it had been investigated and resolved by the registered manager.

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

People and their relatives told us staff were proactive in supporting people to access the health care and treatment they needed. One person described how staff were quick to recognise any health issues and said, “They (staff) are on it here. If there was anything wrong, staff would recognise the signs.” A relative told us how staff had contacted the GP when their relation had an issue with their medicines. They said, “It gives me peace of mind, the staff are all supportive.”

Records showed people were supported to arrange and attend health appointments.

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 tailored in response to this.

Some people who were using the service had learning disabilities and/or autism. The provider had not given due consideration to the principles of Right Support, Right Care, Right Culture (RS RC RC). Staff had not received training relevant to people’s individual needs and this meant they did not have a clear understanding of how to provide people with active support, delivered at the right intensity, to provide a balanced and planned approach to their care. For example, the language used in one person’s care plan was not respectful when describing how the person expressed their emotions. There was no positive behaviour support plan to identify possible triggers and provide guidance for staff in how to support the person in the most appropriate and least restrictive way. Following this assessment the registered manager told us about additional training and support that was arranged for all staff to improve their understanding of RS RC RC

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.

Staff members spoke proudly about supporting a person with end of life care to remain at the service. One staff member said, “It was very rewarding because that was what they wanted, and it was best for them to be in familiar surroundings.” Staff said they had received additional training, including in use of equipment to ensure they could support the person safely.

Records showed that some people had chosen to make plans for end of life are and their wishes were recorded.