Hydon Hill - Care Home with Nursing Physical Disabilities

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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

Whilst care records were detailed around the physical care people required, there were gaps in the provision of supporting those with communication needs to have their opinions and choices heard. This therefore did not maximise the choices for people with a learning disability in line with RSRCRC guidance. Staff demonstrated poor understanding of how to deliver person centred care.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Care plans were detailed in respect of the care people required such as personal care, daily routines and meals. However, care plans contained limited detail in relation to people’s preferences, likes and dislikes. Some care plans stated people liked music and TV, but not detail regarding what they liked to watch or listen to. People’s communication needs were not fully assessed and detailed guidance was not always provided to staff. The registered manager told us no one living at Hydon Hill used communication aids or pictures to support their communication. A person’s hospital passport stated they respond well to pictures. A hospital passport is used to inform healthcare staff on a person’s care preferences if they attend a medical appointment or require emergency care. However, this is not detailed within the person’s communication care plan and no pictures were available to support them.

We received mixed feedback in relation to people and their relatives being involved in planning their care. One relative told us, “Until we insisted, [our loved one] wasn’t even brought into her own review recently. They really don’t involve us relatives.” Another relative said they hadn’t been involved in the care plan although didn’t have any concerns. This demonstrated that people and their relatives were not supported to make decisions on how their care was delivered.

There was a lack of understanding regarding person-centred care, particularly for people with a learning disability. This was seen as how things could be adapted for people rather than the starting point being what people wanted to have or achieve. The registered manager had a focus on people cooking and cleaning meaning these elements of RSRCRC were being met. The registered manager told us, “We try and adapt things, it’s easier in the Willows because they have their own kitchen and can do their own cleaning. We try to set goals now, usually around them going out on trips.” The importance of communication needs being assessed and plans put in place to support people to express themselves was not fully understood. One staff member said, “We had training on Makaton but no one uses it here. For people with learning disabilities here it is total communication needs.” However, they went on to confirm that people with a learning disability did not use communication aids or pictures. This left people with a learning disability at risk of not having their needs understood or met.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Staff spoke about end of life care in a considerate manner. The registered manager told us, “One of the things we do really well is providing end of life care. The staff are really good and [the clinical lead] has put some good stuff in place.” A staff member said, “This is one of the sad parts of our job but it is good to know we have supported them and their families well and stayed with them.”

Everyone had a respect form in place which highlighted where people wished to be cared for, who they wished to be informed and what care they wanted. This meant that staff were aware of how to access information in an emergency or when people were unwell to support their decisions. For people who were nearing the end of their life anticipatory medicines had been prescribed to ensure there would be no delay in accessing this and ensuring their comfort. Staff were trained in administration of anticipatory medicines including the use of a syringe driver.

Documents we reviewed such as Respect forms demonstrated people were involved planning the care they wanted at the end of their life.