Somerset 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 75 (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 were supported to make informed choices about how their care was planned and delivered. The provider clearly demonstrated a strong commitment to person centred care, ensuring people were treated as individuals and their preferences, values and wishes were always respected.

People were actively involved in decisions about their care; care and support plans were developed in partnership with people and, where appropriate, their relatives, carers or advocates. These plans reflected what mattered most to people, including their personal goals, routines, cultural preferences and choices about how and when care was provided. Staff had a good understanding of people’s needs which helped ensure care was delivered in a meaningful and respectful way.

The provider had effective systems in place to identify and respond to changes in people’s needs. People were supported to regularly review their care, and reviews took place when changes were identified, such as changes in health, mobility, emotional wellbeing or personal circumstances. People told us they felt listened to and involved when changes were discussed.

Staff engaged in open and honest conversations, explaining options clearly and supporting people to make choices that were right for them. Where people required additional support to make decisions, appropriate steps were taken to involve others in line with the Mental Capacity Act, ensuring decisions were made in people’s best interests and remained person centred. Staff worked collaboratively with other professionals, such as GPs, community nurses and therapists, to ensure people received coordinated care when their needs changed.

People were supported to maintain independence and control over their lives. The provider encouraged people to be as involved as possible in day to day decisions. Feedback from people and relatives was positive, with comments highlighting that they felt respected, involved and confident that staff would respond appropriately if their needs changed.

The provider demonstrated a clear understanding of the diverse health and care needs of people being supported and the wider local community; this informed the way care was planned, delivered and reviewed, helping to ensure care was joined up, flexible and responsive, while supporting people’s choice and continuity of care.

People received care tailored to their individual circumstances, backgrounds and needs. The provider considered factors such as physical health, mental health, long term conditions, cultural needs, communication preferences and social circumstances when planning care. This helped ensure support was inclusive and equitable, and reflected the diversity of the local population.

Care was well coordinated and integrated with other health and social care services. The provider worked in partnership with the local authority, GPs, community nurses, and specialist services to ensure people experienced seamless care. Information about people’s needs was shared appropriately and in a timely way, with people’s consent, reducing the risk of gaps or delays in care.

The provider supported continuity by maintaining consistent staffing arrangements wherever possible. People told us they valued seeing familiar staff who understood their life histories, preferences and needs; this continuity helped build trusting relationships and supported people to feel safe and confident in the care they received.

Care delivery was flexible and responsive to change. When people’s needs changed, the provider acted promptly to review and adjust care arrangements in partnership with the person. This included responding to changes in health, hospital admissions or discharges, and changing personal circumstances. People were involved in decisions about how their care was adapted and were supported to make choices that suited them.

People were supported to access local community services where this benefited their wellbeing, helping to maintain independence and social inclusion. The provider demonstrated good awareness of local resources and signposted people to additional support when appropriate.

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

People’s communication preferences were included in their care plans and staff ensured these were followed. The provider was meeting the requirements of the Accessible Information Standard (AIS). The AIS tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

Accessible information was available for any person who needed it, for example, one person was provided with information in a different language. The provider ensured people received appropriate, accurate and up to date information to help them understand the care and support available and to make informed choices. Information was presented in ways that reflected people’s individual needs, preferences and communication abilities. A relative told us, “[Person] has a care plan, and it is reviewed. I am always told if there is a problem, and staff talk about it with us.”

People and their relatives were given clear information about the service, including the type of care provided, fees, visiting arrangements and what to expect when living at the home. This information was accurate and kept up to date, helping people to make informed decisions about their care. Staff took time to explain care and support options in a way people could understand. People told us they felt well informed about their care and knew who to speak to if they needed further information or reassurance. People were supported to understand changes which affected them, such as updates to care plans or changes in routines. Where appropriate, relatives and representatives were also kept informed, in line with people’s wishes.

The provider ensured people knew how to raise concerns or make a complaint. People and relatives confirmed they felt comfortable raising concerns and were confident they would be listened to. The provider supported people to make informed choices and remain actively involved in their care. A person told us, “They [staff] give me information; it is easy to understand.”

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 were encouraged to express their opinions, and the provider demonstrated feedback was welcomed, acted upon and used to improve the service. People told us they felt comfortable speaking with staff about their care on a day to day basis. A person said, “I like it here. I would speak to 1 of the staff if I had any concerns; not spoken to them as I have had no concerns.”

Staff were approachable and took time to listen, responding respectfully and taking people’s views seriously. Regular informal conversations enabled staff to understand what was important to people and to identify any issues early. A person said, “We have meetings for all the people who live here; we talk about the food and activities and I feel listened to. If I suggest something they [staff] will do it.”

People and relatives told us they were confident concerns would be listened to and addressed promptly. People were actively involved in decisions about their care and support. Staff worked closely with people to discuss care options, review care plans and agree any changes.

Decisions were made in partnership, ensuring people’s preferences, wishes and goals were central to care planning. Where appropriate, relatives or representatives were involved in line with people’s wishes. People told us they felt involved and reassured when changes were discussed with them, rather than decisions being made without their input.

Feedback from people and relatives was used to make improvements. The provider could demonstrate examples of changes made as a result of comments or suggestions, and staff shared this information with people so they could see the impact of their involvement. This helped people feel valued and confident that their views made a difference.

The provider supported a culture of openness, respect and continuous improvement by making feedback easy to give, involving people in decisions about their care and clearly communicating changes. Feedback from recent questionnaires showed people were consistently happy with the care provided, and where they had made suggestions for changes, these had been listened to and acted upon.

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

The premises were accessible with no physical barriers. Staff ensured people accessed care, treatment and support when they needed to and in a way which worked for them; this helped to promote equality, remove barriers or delays and protected people’s rights.

People’s needs were assessed thoroughly before admission and reviewed regularly to ensure the service could meet their needs effectively. The provider took appropriate steps to ensure people were only admitted when their needs could be safely and appropriately supported, helping to promote positive outcomes and continuity of care. Once living at the home, people had timely access to health and care services. Staff were proactive in monitoring people’s wellbeing and acted promptly when support was required. This included arranging GP visits, referrals to community nurses or specialists, and supporting people to attend external appointments when needed. People and relatives told us staff responded quickly when concerns were raised.

There were sufficient staff available to meet people’s needs in a timely way. Staffing levels were flexible and adjusted when required, for example during periods of increased need or changes in people’s health; this helped ensure people received support when they needed it, without unnecessary delays.

The provider worked closely with external health and social care professionals to support equitable access. Staff followed up referrals and appointments to ensure people received the care they were entitled to and did not experience barriers or delays in treatment. Information was shared appropriately, with consent, to support coordinated care.

People told us they felt supported to access the care and treatment they needed and were confident staff would advocate on their behalf if required. Relatives also said they trusted staff to act quickly and in people’s best interests.

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 provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes. For example, at the time of the inspection, a person was being supported to celebrate an important religious festival; staff had decorated the home and ensured the person was supported to purchase and wear traditional dress, relevant to the celebration. We observed this person was clearly enjoying the festivities.

People and relatives did not report any concerns about discrimination and were supported with the development of positive relationships with peers. Staff received equality and diversity training and there was an equality diversity policy in place to provide guidance.

People were provided the opportunity to share what was important to them if they chose to. The accommodation did not have any barriers to access and had a positive relaxed atmosphere in all areas.

The home had made connections with communities outside the home, for example schools and local events. The registered manager said, “There are a number of barriers that can affect people, including communication (language, literacy, anxiety, cognitive impairment), cultural or religious needs not being understood, physical or sensory needs, past negative experiences, or lack of confidence. We would identify any of these by ensuring our pre-admission assessments were person-centred, through staff observations and reflection, feedback, complaints and compliments, and conversations with people and their families.”

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.

People were encouraged to talk openly about their wishes for the future at a pace comfortable for them. Staff had regular conversations with people about their goals, care preferences and longer term needs, and these discussions were clearly reflected in people’s care plans. This helped ensure care remained aligned with what mattered most to each person.

The provider supported people to plan for changes in health or circumstances. Care plans were reviewed regularly and after any significant change, allowing people time to consider options and make decisions about their ongoing care. People told us they felt involved and supported during these discussions and did not feel rushed into decisions.

End of life planning was handled with dignity, compassion and respect. Where people chose to discuss their wishes for the end of their life, staff supported them to record preferences which were clearly documented and shared appropriately to help ensure they were respected.

Relatives were involved in planning discussions where people wished, helping to ensure shared understanding and support. Staff worked closely with health professionals, to ensure care was well coordinated.

Staff had a good understanding of people’s individual wishes. The provider showed a thoughtful and proactive approach to planning for the future. By supporting people to consider important life changes in advance, including end of life care, the provider enabled people to make informed decisions and feel reassured their wishes would be respected.