Gloucestershire House - Care Home with Nursing Physical Disabilities

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 outstanding. At this assessment the rating has changed to good.

This meant people’s needs were met through good organisation and delivery.
 

This service scored 71 (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. Although some of the care plans, were missing guidance, staff had a good understanding of what person-centred care meant in practise. For example, one staff member described in detail the steps they took when supporting one person with their hygiene needs, in order to meet the individual’s personal choices, about the order in which care was provided and water temperatures.

People felt involved in planning and reviewing their care. One person said, “I am happy with all my care. They have to listen to what care I need, if I want things done on a different day they will do it. Every couple of months I fill out a survey, have to rate the care here as honestly as I can.”

People’s relatives felt involved in people’s care and decisions around this. Comments included; “Good overall” and “Excellent, not a bad thing”.

People who received commissioned one-to-one support were supported by a dedicated staff member referred to as a 'personal assistant', a term chosen by people living at the service, reflecting a personalised approach to care and support.

A professional told us; “Based on my experience working alongside Gloucestershire House, I have found the service to be person-centred, well-managed, and genuinely committed to achieving positive outcomesforthe people it supports.”

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 they tended to work in the same areas of the service, which meant they had got to know people well. They told us this also promoted continuity of care for people. Staff and people told us that although there had previously been a reliance on agency staff, this was no longer the case.

People had access to health care professionals when required. The service was visited weekly by a local GP, and staff told us they were able to seek professional advice and support between those visits.

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 when people experienced difficulties with speech care plans were informative and clear. Staff knew which people needed additional support with communication and were able to tell us how they met these needs, including for example, recognising facial expressions, or the use of tools. Some people used assistive technology and staff were knowledgeable about this. One staff member said, “We need to take more time for those people who are non-verbal. We have to be patient and take our time when we are speaking with them.”

We observed that when staff were communicating with people who presented as non-verbal, they had a good understanding of their body language and were able provide them with what they wanted.

There was clear signage throughout the building which supported people to find their way around safely and independently.

People’s relatives were generally positive about the communication with the service, with some suggesting improvements in efficiency were required, for example in communicating changes and updates.

People and relative meetings took place, and feedback was sought from people via surveys. We reviewed the results from the latest people survey which included the areas of improvement identified and actions taken.One person told us; “We have a residents meeting, and we can make a suggestion.”

Systems were in place for people, relatives and representatives to raise complaints and concerns. Records showed that where concerns had been raised, these were being responded to. They also showed that feedback was captured from visitors to the service such as health and social care professionals or contractors.

People told us they felt staff listened to them. Comments included: “Staff listen to any worries; they help me quite a lot here.” and “Yes, staff do listen to me, any problems get sorted out quickly.”

Some relatives told us they didn’t consistently receive questionnaires about their views of the service but confirmed that relatives’ meetings were held regularly and they shared their feedback.

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

People’s needs were assessed before they moved to the service and when people’s needs changed, records showed staff had referred people for appropriate specialist support and advice.

The environment supported accessibility for people, with wide corridors fitted with handrails and adapted toilets and bathrooms. All areas within the service were wheelchair accessible and work was ongoing in order to make all outdoor areas safe and accessible. One person told us that although the outside work was taking longer than they would have liked, the areas that had been completed were easy to move around in a wheelchair. Another person said; “I never feel isolated here, (I am) included in things.”

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Care plans included information about what was important to people, such as family relationships, social interests, and cultural or spiritual needs and records showed staff used this information to provide care that was fair and personalised. We saw examples of how different cultures and religious festivals were explored and celebrated with activities, such as food experiences.

The people living at the service had been involved in creating and delivering bespoke training sessions to the ‘People Team’ at Leonard Cheshire and to children from a local pre-school to raise awareness about disabilities.

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.

At the time of our inspection, nobody was receiving end of life care. Some people had shared their chosen wishes in relation to their end-of-life care, but not everyone had wanted to do so. This was recorded and staff reviewed people’s choices during care plan reviews.