Homelands Nursing 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 inadequate. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 did not always recorded people’s wishes to demonstrate they were at the centre of their care and treatment choices. People’s care records required more work to ensure their wishes were documented to allow staff to know them and their preferences well. We reviewed a person’s records who was known to decline personal care, their care plan was lacking in detail and stated for staff to ‘leave and return’ if they declined care. Consideration of other ways the person could be encouraged were not documented, for example, for another staff to offer support. We reviewed records of a person who lived with Parkinson’s disease; their care plan detailed the clinical aspects of the condition but did not include how Parkinson’s disease affected the person and what could be done to improve their life. The provider was aware of the need to incorporate person-centred detail into care records and had included this in their service improvement plan. Relatives spoke about their involvement with care planning, their comments included, “I was shown one (care plan) earlier this year and talked it through with the nurse. Earlier this year we did a review at the office. I must have signed a care plan. My views were listened to.” And, “We are booking an appointment with the nurse to formally discuss a review about [person’s] care. Things like what’s working well or needs development. I would like 3 monthly reviews. We discussed assessment of needs but not a current care plan. We haven’t seen a formal care plan We’ve not signed a care plan.” Although people’s preferences were not always documented, we observed person-centred care which people appeared comfortable with. Relatives told us they were kept informed about their loved one’s health and welfare.

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. Staff engaged with a range of health and social care professionals. This included GPs, Tissue Viability Nurses (TNVs), and dementia specialist teams. A visiting healthcare professional told us, “They have been communicating with us in an appropriate and timely fashion regarding concerns about their residents, often via email, or telephoning in more urgent situations.” Another commented, “I have felt that there has been a positive change in the last 6 months since seeing a different patient some time ago. The staff are much more open to discussion around patient’s care and take on our advice more effectively. It generally seems like a nicer atmosphere than this time last year.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service met the Accessible Information Standards (AIS), documents were available in formats to suit people’s needs, for example, menu choices were available in pictures. We saw people were given activity schedules and meeting minutes to remind them of events and discussions. We reviewed a person’s care plan which detailed how staff could support them to express their needs, they experienced some sensory loss and relied upon technology and adaptations. We saw staff supporting them well and utilised the adaptations on offer, a member of staff was learning British Sign Language to further increase channels of communication. We received feedback from a visitor who suggested more could be done to support people with sensory loss when attending external appointments.

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. At our last inspection there were limited mechanisms in place for people and their relatives to provide feedback about their care and the service. Improvements had been made, there was an accessible suggestion box in the foyer and the provider had distributed questionnaires for people and their relatives to complete. Complaints were logged and responded to, people and their relatives commented, “If I needed to complain I would talk to the managers.” And, “The only complaint was about calls to go to the loo not being heard earlier. But that is being listened to.” We were aware of an ongoing complaint where the complainant was dissatisfied with the provider’s initial responses, this was being investigated further by the provider to address. A log of complaints was kept ensuring they were responded to in a timely way and in accordance with the provider’s policy.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Works had been completed to make the Coach House more accessible and easier for people to remain orientated to time and place. Dementia friendly clocks and signage was positioned around the service to help people remain orientated to time place. People now had photographs or pictures of their hobbies and interests on their bedroom doors to help them identify their personal spaces. The new management team were in the process of moving their office to a central location in the Manor House, this was to ensure people and relatives could easily access managerial support if needed. A visitor told us how their loved one’s personal space had been designed to suit their needs and accessibility, they said, “The décor is fine. [Person] likes the pictures in the home. [Person] has all their pictures in the room. They have their own tv, i-pad and portal in the room.”

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 and managers spoke up for people who were at risk of barriers to care and engaged with healthcare professionals to ensure they were receiving the right support and treatment. A relative said, “The home has got a new, really good wheelchair which is comfortable and now we can take [person] out into the garden.” A visiting healthcare professional commented, “I had communication with [nominated individual] and also a different manager who was on call. They both seemed helpful and happy to take on board our suggestions and their main concern was the person's wellbeing and safety.”

People were not always 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. In depth discussions around people’s future care and end of life wishes were not always held and documented, although some decisions were recorded, these were in respect of practicalities. The management team were in the process of arranging reviews with people and their relatives to detail how they would want to be supported holistically, in line with their wishes and preferences.