Coldwells 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 outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making 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.

The provider ensured overall care was responsive and tailored to each person’s individual needs, preferences, and circumstances. Staff knew people well and responded promptly to changes in need, acting to minimise discomfort, concern, or distress.

For example, the provider noticed 1 person experienced continual weight loss. The provider used creative way to improve the person’s dining experience through linking it to their past. They found the person was committed to their Christian faith and spent large parts of their lives helping others. They took extended periods away from work to deliver food parcels internationally on humanitarian work. The person ran food kitchens providing meals for people who were homelessness and in need of support due to hardship. Food, for the person, was never just about eating; it was about caring for others, dignity, and connection. Reflecting on this, staff realised that when the person moved into Coldwells House, food may have lost much of its meaning. Meals were something provided to the person, rather than something connected to their lifelong values and purpose, and this appeared to affect their interest in eating. In response, the person’s care was adapted. Staff including the kitchen team worked closely with the person and their family to ensure food choices were familiar, meaningful, enjoyable and reflected the person’s life and their experience. The person was encouraged to see mealtimes as social occasions again and was supported to eat with their family and people close to them, restoring the sense of connection that had always been important to them. This resulted in addressing the person’s weight loss and enabled the person to maintain a healthy weight.

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 provider involved people and their families in developing care which promoted choice and continuity. Local community groups were involved in the care home and people were supported to have access to a wide range of interests. For example, a knitting group had been developed as a way for the people to show off their amazing work and to socialise together. The activity group created a strong social group and helped to improve motor control and built movement back up and minimised the effects of limited movement. One person told us they were very proud of their blankets and soft toys they had made. Less able knitters were also welcomed.

Staff worked flexibly and in a joined-up way with healthcare partners, taking appropriate action when there were gaps in people’s care. This included requesting funding reviews in a timely manner when people’s needs changed.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider used new and creative ways to adapt technology in order to allow people to access information in formats suitable to them. For example, 1 person was no longer able to read written information and could not reliably hear verbal communication without appropriate support. The provider sourced a digital hearing aid that connected wirelessly to the person’s mobile phone. The digital hearing aid offered an improved hearing experience by automatically adjusting to the sound of environment. Their settings were personalised, and they could connect to other digital devices. Due to their visual impairment, the person used a magnifying illuminated mirror to support their remaining vision during personal care tasks, such as hair and make-up.

In another example, a person’s specific heath condition had progressed, and their verbal communication had gradually declined, and they increasingly began to communicate predominantly in a foreign language. This reflected the person’s lifelong love of languages and their professional background as a former foreign language teacher. Recognising the importance of ensuring the person continued to receive information in a way they could understand, the service worked in close partnership with the person’s family and a fluent foreign language-speaking staff member to develop personalised communication tools in the foreign language. Together, key words, phrases, and reassurance prompts were collated, including language used to explain care, offer comfort, and support daily routines. These phrase sheets were shared with the wider staff team to promote consistency and confidence in communication.

People with hearing impairments were fully involved in their care plan reviews. During care planning meetings, all aspects of their current needs and planned support were read aloud and discussed with them.

The provider produced care plans in easy-to-read format for people with learning disabilities. These were discussed with people and where appropriate with their families and advocates.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

The provider listed to people’s needs and improved their lives by using new and innovative technologies. For example, 1 person was identified as high risk of falls on their admission. The person found monitoring equipment intrusive and regularly disconnected a sensor mat, making it ineffective and increasing the risk of unwitnessed falls or any falls not detected until a room check was completed. The mat when connected was also reactive in nature, alerting staff only once mobilisation had already occurred, limiting opportunities for early intervention. Following assessment and shared decision-making, acoustic monitoring was introduced by Coldwells House as a less intrusive and more acceptable alternative. The person agreed to this approach, which was identified as a less intrusive option to maintain safety while reducing falls risk. Acoustic monitoring alerts staff to sound and movement, enabling a proactive response before a fall is sustained, and allowing routine night-time checks to be reduced, supporting improved sleep. Evidence showed the person’s falls had reduced from near-daily occurrences to 1 fall in the last 3 months since the changes were implemented. Reduced intrusive night-time checks had also led to improved sleep, increased confidence with mobilisation, and enhanced overall wellbeing, while maintaining safety and respecting the person’s independence. The person’s relatives reported that the person was much happier and more settled overnight and less anxious about mobilising. Another relative had noted a noticeable improvement in the person’s mood, comfort, and engagement during visits, and expressed confidence in the care team’s proactive and responsive approach.

In another example people with a keen interest in local history were supported to participate in a community visit to Hereford city. The outing included time to socialise over refreshments in a café, followed by a guided tour of Hereford Cathedral. This carefully planned activity promoted meaningful social engagement, strengthened community connections, and provided culturally enriching experiences that reflected people’s individual interests and preferences.

The provider made sure that people could access the care, support and treatment they needed when they needed it. For example, a person had complex medical needs and required support to attend regular outpatient appointments, including urology and orthopaedics. Due to their health needs, the person was unable to attend these appointments independently and consented to staff supporting them with all appointments to ensure they were not disadvantaged due to their frailty and lack of other support. Staff coordinated all of the person’s health appointments, accompanied them, and ensured information was shared accurately and the person’s needs were clearly understood.

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.

Staff had completed training around Equality, Diversity and Human Rights (EDHR), which helped to recognise, promote and protect people's protected characteristics. Staff showed a good awareness of what discrimination meant and how to challenge any concerns. Processes were in place to help ensure people’s care, treatment and support promoted equality, removed barriers and protected their rights.

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’s relatives provided multiple examples of the service going above and beyond of their duty in supporting people and their relatives when providing end of life care. One person’s family mentioned the service provided accommodation for them whilst their relative was receiving end of life care, so they could stay with them, and it made a huge impact on them as they lived a long distance away from the service. The relatives told us staff offered to come and stay with a person on their day off if relatives needed a break. They also told us they were offered being picked up from a hotel if they needed a break. The family members wrote, “On every visit we felt we were entering a warm and caring environment, and we were acknowledged and made to feel welcome by everyone we encountered. However, that extended visit, spending days and nights with Mum, allowed us to fully appreciate how special your team of staff is.”

Staff received end of life training and provider received Gold Standards Framework End of Life (GSF EOL) accreditation. GSF EOL isa national quality award recognising excellence in end-of-life care for health and social care organizations, including hospitals, care homes, and domiciliary services.