Betsy Clara 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 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 worked in partnership with people, to decide how to respond to any relevant changes in people’s needs. Care plans were very detailed in relation to most areas of people’s care and support needs as well as nursing needs. Care plans were person centred and included individual preferences, likes, dislikes and favoured routines. However, care plans were not always updated and clear. For example, a care plan did not have an up to date list of the person’s medicines. It also stated the person’s food needed to be pureed due to swallowing difficulties. However, the management team stated the person did not have swallowing issues and the person preferred soft food. They said that they would update the care plan accordingly.

Staff knew people well. They described their likes, dislikes and preferences and we observed people responding well to staff. We observed staff getting to know a new person who had moved to the service whilst we were carrying out the assessment, they were patient, reassuring and calm and helped the person to settle in well.

Relatives told us their loved ones received personal care to meet their needs and were supported to dress appropriately. A relative said their loved one, “Loves a bath and she gets one.” Another relative told us, “I’m really happy with dads care.” A person told us, “I have my hair done.”

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. Information was shared with staff during handover regarding any changes to people’s health or care needs. The service worked with other health professionals involved in people’s care. Staff told us how they supported people and their relatives. Relatives told us they felt staff supported people with appointments and communicated well with GPs and health specialists to ensure people received continuity of care. A relative told us, “My husband is made aware of everything that happens here.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. There was a lack of dementia friendly signage and way marking around the service to direct people to communal areas. There was no dementia friendly signage on doors such as toilets, bathrooms and shower rooms. Staff were aware of people’s individual communication needs for example, people who may have hearing or visual impairments. There were some notice boards around the service which had some easier to read information on display.

Staff shared how they provided information and communicated with people. For example, a person did not speak English. Staff used simple phrase translation cards and utilised online translation tools when speaking with the person. They also picked up on people’s nonverbal communication such as facial expressions, eye movement or use of hands (thumbs up or down).

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.

We observed good practice from staff in relation to listening and involving people with their care and making decisions. The registered manager shared with that they held meetings with people and relatives on a regular basis. Updates about the service were also shared at these meetings. People and their relatives were sent surveys about the service. The nominated individual for the provider told us, “We carried out a survey of all our relatives and residents’ friends across the group last year. Betsy Clara had 13 responses. Of those, 100% stated the home made them feel welcome when visiting and that staff treated their relative/friend with kindness, consideration and care.” The survey results were reported to the board of directors and reviewed by the provider. Staff surveys had been sent, most of the feedback from staff had been positive, a small number of staff had raised some issues, and the provider was working to address these. The human resources team were supporting with investigating areas raised.

People were offered informal opportunities to feedback about the service, the management team spent time walking round the service daily and chatting with people. The service published relatives and resident newsletters regularly, recent copies showed people and relatives had been informed about external events such as musicians and singers, dates of relatives’ meetings, updates about staff training. The newsletter also provided information about the service not currently having a visiting hairdresser and explaining they were trying to find a new one. It gave details on when the barber, chiropodist and manicurist were visiting. The back page of the newsletter provided contact details for the provider’s accounts department, the human resources department and contact details for the management team.

The provider made sure that people could access the care, support and treatment theyneeded when they needed it. People were supported with medical appointments and follow up appointments. We observed people receiving visits from healthcare professionals during the assessment visit. People’s care records showed that they had received medical help. Relatives told us their loved ones has visits from healthcare professionals. People told us they had access to the nursing staff within the service as well as visiting health professionals. Staff gave us examples of when they had recognised people were not acting in their usual manner and the action they took. Staff were knowledgeable about how to recognise signs of deterioration and care workers said they would report health changes to the nurse on duty if necessary. People were supported to maintain contact with their friends and families. We observed people receiving visits from friends and families during the assessment. People were able to access the garden; this was secure and had plenty of seating areas in the sun and shade to enable people to access fresh air. Volunteers were on hand to support with additional activities to meet people’s needs. The registered manager told us a volunteer has provided 1 to 1 support to people to meet their spiritual needs, such as bible reading. Shortly after our assessment visits the service conducted their own harvest festival which was led by staff.

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.The provider had a clear policy in place in relation to equality, diversity and inclusion. The provider set out in their brochure; ‘At Betsy Clara House, we are passionate about the service we provide and caring for our residents. We are committed to providing the very best care and we recognise that our residents require varying levels of support. We are able to tailor the care we provide to the individual needs of each and every one of our residents.’ We observed that all the staff were passionate about the people they were caring for and people’s care and support was tailored to their own needs and wishes. A staff member said, “I enjoy the job and find it meaningful. I am passionate about resident care and supporting independence.” The service had regular visits from some staff members dogs. We observed that people enjoyed having the dogs for company and spent time seeking the dogs out. A relative said, “The 2 dogs are nice, they make it a homely feel.”

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 and processes in place to understand the diverse health and care needs of people living at the service. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. Some people had ReSPECT (Recommended Summary Plan for Emergency Care Treatment) forms in place. A ReSPECT form records a person's wishes about a range of care and treatments.

End of life care plans were as comprehensive as the person wanted it to be and plans were clear in cases where people had chosen not to discuss this element of their care. The service provided some care to people at the end of their lives. Staff told us that they worked closely with the local hospice to ensure people had effective support and pain relief to ensure people had dignified, pain free deaths. Medicines were available to keep them as comfortable as possible. Staff told us they had attended training to support people at the end of their life. A staff member said, “We have some families who visit people at night when their loved one is at the end of life. I offer lots of support.”

The service had received thank you cards from relatives of people who had passed away. A card read, ‘We would like to thank you all for the kindness and care you gave [name] while he was resident here, making his last days comfortable. Betsy Clara is a very special home and so is everyone who works there.’