Te Hira Care Home Limited

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 Good. At this inspection the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 told us they received person centred care and liked living at the home. They said staff were respectful and responsive. People’s rooms were personalised with their own possessions to make them more homely, and people were offered daily living choices such as what they wore and how they would like to spend their day.

Staff knew people well and were able to describe their needs fully and clearly. This meant staff were able to provide care in accordance with people’s wishes and preferences. For example, 1 person could present with distressed behaviours, stating that they wanted to return to their home. One staff member described how they helped the person at these times. They told us, “We spot their triggers and can see when it’s starting as they may wander around enough for us to know. They work very well with distraction, we say ‘help us set a table or fold washing’.” Staff explained how responding promptly to signs of distress helped reduce this person’s agitation. Another staff member said, “We are here for the residents. Our priority it is doing what they want and need us to do. It’s individual care for individual residents.”

The provider told us how 1 person’s needs had changed so they needed more care than staff were able to provide in the morning. In response, they had requested a reassessment of the person’s needs with the commissioning authority to enable additional support to be provided through an extra staff member.

Care plans contained some information about people’s preferences, likes and dislikes. For example, 1 care plan stated a person preferred a ‘wet shave’. Others showed people’s preferred time to have a wash or shower.

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

People were supported by familiar staff who knew them well. People had access to services such as hairdressers and a chiropodist who visited the home.

Relatives told us they were welcomed into the home and stated communication systems were good which meant they were able to keep in touch with the service about the care of their family member.

Staff told us how they communicated information across shifts, so people received continuity of care. The provider also accessed the local community in relation to social events for people. For example, school children came into the home to spend time with people doing activities.

A nurse practitioner visited the home weekly and staff worked closely with them and other healthcare professionals to support people’s needs.

The provider did not always supply information in formats that were tailored to individual needs.

Whilst people were provided with information about the home, consideration had not always been given as to whether people could easily read or access this information. For example, a complaints procedure was in place, but this was not on available in large print, other formats, or on display. This meant people may not always have had the information they needed in a format that supported their understanding or decision making. Management staff told us this would be reviewed.

Staff told us they felt there was effective communication in the home. One staff member said, “I would say communication is good, we have handover (meeting at the start of each shift) and we have all the records to read. It keeps us up to date.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff aimed to involve people in decisions about their care or tell them what had changed as a result.

Processes to obtain regular feedback from people and give people an opportunity to discuss the service, plans and any improvements could not be demonstrated. For example, records of resident meetings could not be readily located when requested.

Following the inspection the provider supplied records showing resident meetings had taken place where people had been given opportunities to comment on the food, activities and their experience of living at the home. However, the inability to readily access these records at the time of the assessment reduced assurance that the provider had oversight of formal feedback processes.

Information about how to raise concerns was not easily accessible to all people living at the home. For example, the complaints procedure was not produced in a format that people could always read or understand which meant they may not know how to share their concerns or any issues they wished to discuss relating to the service.

Relatives told us communication with the home was good and they had regular contact with staff to discuss their family members. Where people had raised concerns, these had been recorded, responded to and actions taken where appropriate.

Staff told us they would talk with people if they were not happy about something. One told us, “If a resident wasn’t happy or their relative was not happy, I would talk things through with them. I would listen and try to understand what was wrong. If it was a niggle and I could sort it, I would. If it was something big, I would tell the manager so they could talk to the resident or relative and resolve things.”

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

Referrals had been made to external health and social care professionals when people needed them. Some people were visited by the district nursing team, and staff told us they had good working relationships with the practice nurse that visited the home each week.

People had access to a lift if their room was on the upper floors. Some people were able to use the stairs to access their room.

Staff were aware of those people with sight and hearing impairments. They supported these people to access optician and audiologists to ensure they had the treatment and equipment they needed to meet their sensory needs.

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.

Staff ensured those people at higher risk of experiencing inequality were supported and their needs met. A staff member described how they ensured people with dementia were included in activities provided by adjusting the activity to ensure they could participate. We saw how people who would have some difficulty standing for periods of time participated in a skittles game whilst still seated. The staff member who provided activities told us how they would spend time with people who were cared for in bed to ensure they had some social stimulation.

The provider was committed to ensuring all people living at the home were treated fairly and had a good experience of care. This included people with protected characteristics.

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.

The provider had systems in place to ensure people’s preferences for care and support were obtained should they become seriously unwell and required end of life care. For example, 1 person had a care plan which stated their wishes in regards to being resuscitated in the event of deterioration of their health condition. Anticipatory medication had been arranged for a person whose health was likely to deteriorate. This was to ensure when they approached the end of their life, this could be administered to keep them comfortable if needed.

A health professional had provided positive feedback to the service on how they had managed the care of a person at the end of their life. They stated how staff had dealt with a person and their family with “utmost respect” and how the person had been surrounded by care staff who had treated them with care and dignity. They were also complimentary of management staff who had worked with health professionals including district nurses, ambulance crews and urgent care teams with “efficiency, empathy and compassion.”