Mary House

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.

However, we found some minor discrepancies in peoples care plans and risk assessments which were fully discussed, taken forward immediately and reviewed and had no impact at this time on peoples’ safe outcomes. It was also discussed that daily records were task based with minimal reflection of peoples’ moods and behaviours. Whilst staff were knowledgeable about how each person showed pain or discomfort, this was not always explored and a monitoring tool used to monitor effectiveness of pain relief medicine. These were fully discussed during the inspection process, and were being addressed.

Care and support were provided in a person-centred way with people being at the centre of any decision making and their loved one’s views being asked for and listened to. People received the ‘right care’ with their rights, privacy and dignity being upheld at all times.

Care provision was tailored to meet people’s needs, and this was also reflected in care plans which described the person, any preferences they had for the way they were supported and then went on to describe the actual support required. The care plans detailed people’s specific health needs which were individual to that person. For example, there were people who lived with epilepsy and each person had their own personal plan which detailed how it impacted on that person and what staff needed to do in the event of a seizure and post seizure. Care plans consistently reflected people’s physical, emotional, social, or cultural preferences in sufficient detail, and there was evidence of regular involvement from people or their representatives in reviewing and updating care arrangements. Mary House consistently up held the principles of person-centred care, and opportunities to tailor support around individual needs and preferences were taken to enhance positive outcomes for people. For example, introducing hydrotherapy and eye gaze technology. We saw people were engaged in different activities that they enjoyed, and that that were stimulating and engaging such as music sessions, a birthday celebration and other 1-1 sessions in the sensory room. Some people were engaged in physical therapy time which included standing in a specialised frame.

The activity programme was reviewed regularly to ensure people received opportunities to do the things they enjoyed. The home's hydro pool was in use daily, and a relative had recently arranged an afternoon tea party for everyone. There were 3 home vehicles and regular trips out were arranged and thoroughly enjoyed by people. A staff member told us “We do lots of different things to ensure we continually engage with people; music karaoke is a favourite for some people. We have been doing cooking, and they get to eat the cake!

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. Relatives told us they felt well informed and assured that if needed, specialist advice would be sought straight away. Relatives told us, “Very organised, appointments arranged so we can go if possible if we can’t staff, will keep us informed,” and “Staff are so very good, and they ensure we are involved in all decisions and updates.”
A health professional told us, “Staff knowledgeable, professional and polite. They know people well and contact us when needed.” We were also told, “Very pleased with the home, I can relax knowing my loved one is safe and happy.” Staff told us that they worked alongside families and always informed families of any appointments and kept a record of the appointment and advice given.
The manager demonstrated an awareness of inequalities in accessing healthcare services and emphasised the importance of a holistic approach to care. They ensured that support was not narrowly focused on a single health condition. For example, when supporting individuals with a learning disability, staff did not assume all care and support needs were solely related to the learning disability. Instead, they considered the wider context of each person’s physical, emotional, and social needs. Care plans were regularly reviewed and contained detailed information about people's care needs, including any health and medical needs. They also included evidence of regular partnership working with health professionals such as specialist nurses, and therapy teams. These records were well documented and showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making.

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

People living at the service were not able to communicate verbally Staff told us there was a range of different communication aids that could be used if appropriate, but at present were not in use. Care plans referred to how people used various noises, blinking, moving their head and other methods to communicate and this was clear in their individual risk assessments and care plans. There was also input from the SaLT team regarding communication and reference to eye gaze technology and eye contact.

Care plans included a Distress and Discomfort Tool (DisDat). These are charts accessible to people who cannot verbally communicate, on which they can indicate how they are feeling, for example, happy, sad, anxious or unwell.

All care plans were on a computer, and this enabled them to be printed off for family, hospital appointments and transfers. They could also be enlarged for those that have sight impairment. We were informed that all organisational documents could be provided in an alternative language if required.

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.

Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions proposed and taken, were then discussed at the next meeting.
There was a complaints policy and procedure, we saw that concerns raised had been responded to promptly and thoroughly. The management team kept a log that ensured the manager had an overview. They told us they had an open-door policy, and we saw staff and relatives talking to staff to share information and ask questions. Relatives told us, “Communication has improved considerably, I feel reassured that I can talk to the manager.”

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

People had access to health and social care professionals which meant that they received the best and most appropriate care and support when required. We spoke with professionals who confirmed that there were good lines of communication between them and the service and that they were contacted for appointments, support and advice in a timely way that immediately addressed people’s needs.

A health professional tod us, “The clients I have visited have often involvement from the learning disability team and diabetic team.” Another added, “Very clear records of all health professionals involved in peoples care.” Accurate records of appointments and interventions were kept as part of care plans which then provided a complete medical history for people for future reference.

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.

Activities were tailored to peoples likes and based on their interests. They were able to engage in 1 to 1 or group sessions according to their wishes. Activity timetables were flexible depending on peoples presentation on a daily basis. People were supported to go out on trips and excursions. Activities within the service were also provided by visiting guests, for example animal therapy. Visiting entertainers attended regularly. A relative said, “They have a good social life, they go out on trips, take part in parties and there is always something going on, much improved over the past year or so.”

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.

Where appropriate, loved ones were involved in planning discussions, helping to ensure decisions reflected what mattered most to the person. Preferences for their care at the end of life, were documented in their care planning records. This included details about the preferred place of care, as well as cultural, spiritual, and personal wishes.

People had ReSPECT forms. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment and ensures their personal wishes are followed. These were currently being reviewed by the GP.

Some people also had a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decision, also known as a DNR (Do Not Resuscitate) order,which were accessible to all staff and health professionals should a situation arise. Relatives and friends were supported with compassion through this difficult time. For example, there were no restrictions to visiting for those people at the end of their lives, as long the privacy and dignity of other people were respected.