ExtraCare Charitable Trust Humber Court

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 82 (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 received care and support that reflected their individual needs, preferences and wishes. Staff had access to highly detailed, person-centred care plans which enabled them to provide support in ways that were specific and meaningful to each individual. Staff knew people very well and understood not only what support people needed, but how they preferred that support to be provided.

People were actively involved in planning their care and support. Where appropriate, relatives and others important to them were also involved in care planning discussions. Relatives consistently confirmed they were involved, and care plans were reviewed whenever people's needs or circumstances changed. This ensured care continued to reflect people's views, choices and changing needs.

Care plans contained detailed information about people's life histories, personal preferences, dislikes, interests and what mattered most to them. This included significant relationships, previous occupations, countries they had visited and educational achievements, helping staff understand people's backgrounds and experiences. Staff used this knowledge to build meaningful relationships with people. For example, relatives described staff spending time talking with people, reminiscing and encouraging involvement in activities that interested them.

Personalised guidance went beyond people's general preferences and provided staff with detailed information about how to deliver individual aspects of their care. This included how people preferred staff to communicate with them, the approach staff should take when providing personal care or administering medication, and what people could do independently before staff offered support. People's individual wishes and preferences were consistently reflected throughout their care records.

Staff were supported to be flexible when people needed additional time. One staff member told us, “It's OK if you go over your time. If you need to stay with someone, the Team leader will cover your other calls.” Staff also adapted support around people's individual responses to care. Where people were reluctant to accept aspects of their care, staff were instructed how to approach them sensitively and used gentle encouragement rather than imposing routines. Additional support was also introduced where changes in people's circumstances or individual risks indicated this would benefit them.

People's autonomy remained central to the care provided, including where their choices involved risk. Staff respected people's decisions while continuing to monitor their wellbeing and escalate concerns where there were indications that a person's ability to make a particular decision may have changed.

The level of personalised information available, combined with staff's detailed knowledge of the people they supported, meant care was not task-led or based around standard routines. Instead, staff adapted their approach around each person's abilities, preferences, communication and changing circumstances.

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.

The service worked with external professionals and organisations to provide joined-up support that met people’s health and wellbeing needs. The provider employed a wellbeing adviser who visited this service once a week. The adviser supported people to access healthcare, advice and other services when needed, including contacting GPs and escalating concerns on their behalf. They also offered practical support; for example, they gave one person advice about maintaining their skin integrity. A staff member told us, “Their role is for the residents. They will contact the doctors, will escalate concerns. Offer advice and support.” The wellbeing adviser also supported people’s wider wellbeing through activities such as yoga and arranged for external organisations, including MIND, RNIB and Talking Therapies, to visit and provide additional support. This approach helped people access appropriate services and promoted coordinated and continuous care.

People received support from a small team of staff who knew them well. Where possible, the provider avoided routine use of agency staff and used regular staff and bank staff who were familiar with people. People told us they regularly received care from the same staff members. One person told us, “I get the same ones every day they are great.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People received information in ways that met their individual communication needs. Staff had access to information about how to communicate effectively with each person and their preferred methods of receiving information. For example, one person's care plan explained they had poor vision and used hearing aids. Staff were instructed to speak clearly, face the person, minimise background noise by turning off televisions, radios and other appliances, and provide information in large print where required.

The provider identified and responded to a range of communication needs. One person had a communication picture book, and staff were guided to use this to support meaningful communication. People's preferred communication methods were discussed and clearly recorded in their care plans. For example, one person's care plan stated that telephone conversations caused them anxiety, so office staff communicated with them in person. This helped ensure people could access information in a way that was comfortable, understandable and appropriate for them.
Daily care records demonstrated that staff kept people informed about matters affecting their care and support. For example, one staff member documented that they had explained to a person that a referral had been made to external healthcare professionals following concerns that had been identified. This showed that people were kept updated about decisions and actions relating to their care.

The provider also made important information readily available to people. Information was available in large print if required and other useful information was displayed in communal areas, including guidance on how to raise concerns or make a complaint, helping to ensure people knew how to access support and provide feedback about the service.

People and relatives were positive about how the service shared information and kept them updated about changes to the service or people's care and treatment. One relative told us, “They provide updates such as when [person’s] medication increases. They will phone me or email me. The carers know [person] well.”

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.

The management and office team were highly visible and accessible. People and their relatives were actively encouraged to share feedback, raise concerns or make complaints. People felt confident these would be taken seriously and lead to meaningful improvements. A wide range of systems were in place to support this, including both formal and informal methods of communication.

The registered manager adapted how they sought people’s views after recognising that formal residents’ meetings were poorly attended. They introduced informal ‘coffee with [registered manager]’ sessions in the communal area, providing people with a more relaxed opportunity to start conversations, share their views and develop a relationship with the registered manager. Where people wished to discuss personal matters, these conversations could continue privately.

Courtesy calls took place on an ad hoc basis. The registered manager told us they would drop in on a resident they hadn’t seen for a while just to check in, and they were documented within people’s care plans.

Team meetings evidenced staff were to encourage and support people to feedback. People were involved in recruitment and prospective staff members met residents.

Relatives knew how to share feedback. One relative told us, “We would raise any complaints with the care team or team leaders. [Name] has lived there for a few years, so we know them well.”

People were actively involved in monitoring the quality of their care. With the person’s consent, staff competencies were observed while they provided care and support. As part of this process, the person was asked for their views about the care they received, and their feedback was recorded. This ensured people’s experiences and views contributed directly to assessing staff practice and the quality of care provided.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The purpose-built environment met people's accessibility needs

The provider worked hard to ensure people could continue to use the service as long as they could safely meet their needs. For example, adding an extra visit in for a person who was experiencing frequent falls. Their loved one told us, “It means I can relax.”

People had access to a range of healthcare professionals and services, including GPs, opticians and occupational therapists, to support their health, wellbeing and independence.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

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 registered manager was able to share an example of how staff had worked to achieve improved experiences and outcomes for a person whose health condition and communication needs created barriers to accepting personal care. The Dementia and Mental Health Wellbeing Enabler developed an individualised approach involving trust-building, visual prompts, additional processing time, familiar interests and preferred staff. This enabled the person to engage more positively with staff and gradually accept personal care.

People’s individual characteristics, including cultural, religious, communication and accessibility needs were assessed and clearly documented within care plans. This enabled staff to provide personalised care which respected people’s preferences and promoted inclusion.

The provider had relevant policies regarding equality and discrimination, and staff had received training in this area.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

People were asked about their end of life wishes so these could be understood, recorded and respected, helping to ensure their preferences were known and care could be planned in line with what was important to them. Where people found it distressing to talk about, this was also recorded.

The provider maintained accreditation through the Gold Standards Framework. This is a UK-based training and accreditation program that helps frontline health and social care staff provide high-quality end-of-life care which supported a proactive approach to end-of-life care, including advance care planning and multidisciplinary working.

ReSPECT forms, where applicable, were kept in a visible and easily accessible place within people’s homes. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they are not able to make decisions or to express wishes.

We saw that some people had an advance directive in place, and the location of this document was clearly recorded in their care plan. An advance directive sets out a person's preferences for future medical treatment should they become unable to make or communicate decisions themselves. This helped ensure staff were aware of and could respect people's wishes for their future care.

Staff knew where to access important information about people's future wishes and preferences, helping to make sure these could be respected and followed if they were unable to communicate their decisions themselves.

Records showed staff identified signs of deterioration and acted promptly to escalate concerns.

The management team and staff demonstrated a strong commitment to listening to people’s wishes and ensuring they received care and support in the way they wanted. The registered manager shared an example of how they had advocated for a person approaching the end of their life who had clearly expressed they did not want to be admitted to hospital. The management team worked closely with the person's GP and palliative care team to coordinate the support needed for them to remain safely and comfortably at home. They also sourced additional sitting care to help ensure the person's wishes could be respected and that they were able to remain at home in line with their preferences for future care. The carer providing the sitting care had provided feedback which praised staff for the support they offered, commenting that staff made themselves readily available if any additional advice or assistance was needed.

The person’s care plan explicitly documented what was important to them and provided detailed guidance about how they wanted to spend their final days. This included being cared for in familiar surroundings and having personal items around them that provided comfort and reassurance. Staff understood these preferences and used the care plan to ensure the support provided remained centred around what mattered most to the person.

The management team also demonstrated flexibility and compassion in responding to the person’s changing needs. They showed us how staff regularly remained beyond the person’s allocated care time to ensure they were not left alone during the final stages of their life. This reflected the person’s documented wishes and demonstrated that staff prioritised their emotional wellbeing, dignity and comfort rather than focusing solely on commissioned care times. The registered manager told us they were particularly proud that the service had been able to support the person to remain at home until the end of their life, surrounded by familiar belongings and receiving care in the way they had chosen.