Royal Garden Hotel

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 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 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’s care records were person-centred and reflected their life histories, preferences, hobbies and individual needs. Staff knew people well and provided support in-line with what was important to them. Staff responded to individual preferences, including providing alternative meal choices, adapting routines and identifying opportunities to improve people's wellbeing. One relative explained staff recognised their family member preferred a bath rather than a shower and adjusted support accordingly. Care was planned and reviewed with people; staff told us they were able to provide input if they noticed a person’s preferences had changed. People were able to fully personalise their space, including larger pieces of furniture.

The provider understood the diverse health and care needs of people and their local communities. Care was mostly joined-up, flexible and supported choice and continuity. Where people's needs increased beyond the service's admission criteria, staff were open and honest about their ability to meet their requirements and worked closely with families and professionals to support safe transitions to more suitable services. The service recognised the risks associated with increasing or rapidly changing needs and sought advice from relevant professionals to help ensure people received safe and effective care.

We identified an occasion where earlier escalation to designated professionals may have improved an outcome for a person experiencing a change in needs. Professionals were involved in their care; however, more timely access to specialist advice and equipment may have supported them further during a period of health deterioration. A social care professional shared their view and said, "Overall, I feel the service is caring and does the best it can for its current resident group. However, as the majority of residents are relatively independent, I have some reservations about the home's ability to safely manage residents with more complex or rapidly deteriorating health needs." This reflected the challenges associated with meeting rapidly changing needs within a service designed for people with lower levels of dependency.

The registered manager acknowledged the service's limitations and provided examples of people being supported to move to more appropriate settings when required. Other professionals spoke positively about the service. One professional told us, "The staff are all friendly and approachable, and I am contacted promptly whenever advice or treatment is needed. Care and treatment plans are followed well, ensuring residents receive consistent, high-quality support.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff considered people's communication needs and used personalised approaches and assistive technology to support when required. Information was made available in different formats, such as, larger print and staff told us they supported people to read correspondence when needed. A monthly newsletter was circulated to inform people of upcoming events, changes within the service and to reflect on the achievements or challenges of the previous month.

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 and relatives were listened to and concerns were addressed promptly. A person commented, “I am happy here. I like that [nominated individual] has been here since day dot and I've known [registered manager] for a long time. I wouldn't have any problems letting them know if there was anything that was worrying me.” A relative said, “In the past I raised one concern. I went to the manager who dealt with it straight away.” People’s feedback was valued and used to improve their experiences. Relatives told us activities had increased following feedback. We reviewed compliments received at the service, many of which were thanking staff for their care.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People had access to care and support that met their needs. Staff were flexible in responding to people's needs and protected characteristics and made adjustments where required. People were able to personalise their environment, access activities and maintain community links that were important to them including social clubs and religious services. People had free access around the service and went out as they wished, for example, to the beach or out shopping, staff supported them where there was an assessed need or by preference. The staff had recently introduced a shopping trolley which people enjoyed, this empowered those who did not like to go out as much to buy items which were important to them.

Staff and leaders listened to information about people who are most likely to experience inequality in experience or outcomes and mostly tailored their care, support and treatment in response to this. Aside from the one person who would have benefitted from rapid specialist intervention following an increase of needs, people experienced positive outcomes because staff understood their individual circumstances and responded to changes in a personalised way. Feedback from people and relatives was positive regarding the quality of support staff provided. Staff monitored people's health and wellbeing and worked with professionals to improve outcomes. We reviewed examples of when people accessed health and care support in a timely way. A person told us, “If I’ve got any health queries, I get the office to help me make appointments.” A relative commented, “They work well with other professionals. With [person] if there are any problems they get straight on to the doctor.” Care records evidence staff monitored people if there were changes to needs or medicines and reported any adverse effects to relevant professionals quickly.

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 people's health needs changed significantly, the service worked with families and professionals to plan future care arrangements and ensure continuity of support. Relatives and people told us they were involved in discussions when increased support was required and appreciated the management team’s openness when alternative placements were needed. The service worked with relevant health care professionals when people were nearing the end of their lives. They ensured people received appropriate medicines and equipment to promote their comfort.