Bywell House Care 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 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. Staff knew people very well and used positive approaches, such as distraction techniques for people experiencing distress. However, the techniques were not always documented in people’s care records; the registered manager updated these upon our feedback. A health professional spoke of how staff interactions were effective and said, “[Person] is doing very well since medication changes. Staff manage anxiety with space and conversation rather than sedation.” Staff demonstrated a very clear understanding of people’s personalities, including who and what was important to them. A relative told us, “They know dementia and they know the signs. They said to me [person] was wringing their hands so sat with them, distracted them and that was the end (no further anxiety).”

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. Care was well co-ordinated, with strong evidence of partnership working. The registered manager said before people moved in, “I would go to the person’s home, hospital or maybe care home they were in. Always ask to see their care notes to make sure the notes reflect how they really are.” A health care professional said, “Calls to escalate concerns are timely.” Weekly input from relevant health and social care professional supported joined up, continuity of care.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were considered, and adaptations were in place, such as communication cards and pictorial documents. Staff told us how they used gestures and written notes for a person, who was hard of hearing. We observed effective communication between staff and people based on 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 involved people in decisions about their care and told them what had changed as a result. People and their relatives felt listened to and involved. A relative said, “They are very open to comments. They act straight away.” We observed a person raising a complaint about missing clothes, this was addressed immediately by the registered manager to the person’s satisfaction. Complaints were documented with evidence of learning and action taken.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People accessed care and support without barriers. Dementia-friendly signage was in place, and the environment was adapted for people’s mobility. We observed people moving freely around the home, with stairwell risk assessments supporting independence. The registered manager’s office was situated in an accessible location enabling people to visit them freely.

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. People experienced equitable outcomes because staff acted promptly to address health needs and ensured access to specialist services. A person experienced dental issues, the registered manager told us how they advocated for the person and said, "I fought tooth and nail for funding for [person’s] dentist and had confirmation about a month ago." Other examples of how staff supported people to improve their outcomes included how staff were gently encouraging a sleeping pattern for a person to aid a restful night and promote a full, active day.

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 had completed training on the practicalities of supporting people when at the end of their lives and had access to appropriate professionals for advice. The registered manager shared how the staff team supported a person following a bereavement, this included assistance with funeral arrangements and maintaining memory items. Providers are required to notify the CQC of certain events including deaths of people they are supporting. We reviewed these notifications which indicated people received appropriate support as they approached the end of their lives, this included where staff had sat with people during their final moments.