Higher Bank

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 generally met in this area.

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 generally made sure people were at the centre of their care and treatment choices.

People and their relatives felt that people received person-centred care that met their needs. Care plans were person-centred based on the information recorded and included details of people’s likes, dislikes and backgrounds.

Staff spoke about what person-centred care meant. One staff member said, “Weask people what they like, we lookatcareplans to see what people’s needsare.” A registered manager spoke about care plans being person-centred and how they made people’s care person-centred, they said, "They (care plans) have been person-centred from word go. I work to the people not a regime."

During observations at Higher Bank, we witnessed some inconsistencies in person-centred care being provided.

There were some shortfalls in how the provider understood the diverse health and care needs of older people, and care was not always joined-up, flexible or supportive of choice and continuity.

Throughout the inspection staff and management referred to various organisations they could make referrals to for support when needed, but this was not always utilised. We found examples where some referrals were made to ensure people received the right support and treatment, but this was not consistent and records relating to this were not as detailed as they could have been.

Professionals provided mixed feedback in this area. One professional told us, “The service works well with the healthcare team to meet people’s care and support needs within the group.” Whilst another said, “The home has in the past become attached to their residents who have been there for many years.The home can be reluctant to seeking reassessment where care needs may have exceeded the scope of their registration.”

Relatives and people told us they were happy with the care provision.

The provider supplied appropriate, information in formats that were tailored to individual needs, though a registered managers knowledge around accessible information needed to be improved.

A registered manager initially was not able to recall what the Accessible Information Standards were, however on day 2 they brought us a handwritten policy on this. We did also see some limited examples of large print documents to support people who may need this type of communication aid.

People could access information and staff spoke about how they promoted people’s privacy. One staff member said, “We keep everythingasecret, officesare kept locked.” People’s information was safely stored away in a locked room. A General Data Protection Regulation (GDPR) policy was in place. We found people’s records were being securely stored in line with GDPR.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People could express their views or concerns in numerous ways including at resident meetings, through surveys and by raising complaints. People and their loved ones felt they were listened to. Some surveys had been completed in the last 12 months by people, their relatives, staff and visiting professionals. Generally, responses about the service were positive.

Staff told us they would report any concerns to the management if people were not happy. One relative said they would report any concerns to the management, but they have not had to raise any concerns. There had been no complaints made to the home in the last 12 months. Policies were in place to support people sharing feedback, including a complaints policy. However, the complaints policy did not detail necessary external escalation processes such as the local government ombudsman.

The provider generally made sure that service was accessible, and people could access care and support.

Staff felt that home was accessible for people. One staff member said, “The home isaccessible thereare ramps for people in wheelchairsand railsfor people on the stairs.We have stair lifts for those wecan’twalk.”The home was generally accessible for people, there were bedrooms across the various floors in the home, it had grab rails, stairlifts and multiple toilet facilities across each floor. The service had equipment in place to support accessibility in the home.

Professionals generally felt the home was accessible for people, and they also noted that they were able to easily contact the home.

Staff and leaders 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.

Peoples and their relatives told us they felt people generally received good outcomes. One relative said, "I think they look after him, they keep him clean and they keep him fed. Before he came here, he was 2 years in bed he wouldn't get up now he is up most days."

Staff told us they had no concerns about the care the service provided. Meetings for/with residents were taking place, which kept people up to date with any changes and allowed them to discuss any concerns.

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.

A registered manager spoke about the end of life care and how they supported this, they said, "I did work with a hospice in 2012 to do learning in end of life. Care plans have end of life information in them." People’s care plans had end of life details in, and it was recorded if this was something they wished to discuss or not and what their wishes were if appropriate.

We were shown a thank you card provided to the home from a relative who lost their loved one which said, "In her final days I knew she was in the best place possible. Nowhere could have cared for her better. I was by her side, and it was all very peaceful. I will forever be grateful for the love and care that you showed not only to my mum but to all the residents at Higher Bank."

We saw evidence that people had a Do Not Attempt Resuscitation (DNAR) in place where it was their wish.

We were not able to determine which staff had recently completed end of life training. An end of life policy was in place, though this had not been dated, signed or reviewed.