Nationwide Community Care Limited - 3 Cracknell Close

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 as good. At this assessment the rating has changed to 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. Staff we spoke with were all extremely knowledgeable about people, including their individual likes, dislikes, health conditions and sensory needs. This meant care and support could be planned and delivered in an exceptionally personalised way. Leaders modelled a culture where people were at the centre of their own care. The company director told us, “The registered manager works closely with residents to identify their preferences, wishes, routines, interests and what matters to them in their everyday lives. These conversations help staff understand that person-centred care is not simply about meeting people's basic care needs; it is about supporting people to live a life that is meaningful to them.”

Care plans and risk assessments were accurate, up-to-date and contained highly personalised information, such as how people liked to spend Christmas and what kind of presents and specific food they would like. People were supported and enabled to take part in celebrations relating to their background and protected characteristics. Records showed people were involved in regularly reviewing their own care plans, to agree the contents and how they would like their support to be provided, including when feeling anxious or upset. This included detailed information such as ‘A good day for me’, and what this would look like for the individual. People also recorded how they would like to be addressed, including any terms of endearment or nicknames they were happy for staff to use.

Staff worked to ensure people had their preferences met and also achieve goals such as weight loss or healthy eating at the same time, by discussing menu choices with them. On the day of our visit, we saw 1 person was having salmon and roasted vegetables with a cup of peppermint tea for dinner, whilst another person preferred to have waffles and eggs. A relative told us, “[Staff] cut up [person’s] food in a manner that [person] likes and I watched them doing it when they visit. It just makes me feel [person] is in a good place.” Any changes to people’s health needs or diagnoses were updated in records straight away. A staff member told us, “The care standards here are excellent. Care plans and risk assessments are updated instantly when a resident's needs change.”

All of those we spoke with were confident staff knew people extremely well, and confirmed people were safe and well-cared for. One person’s relative told us, “[Staff] understand [person] more than I do these days.” A professional who worked with the service told us, “I have always found [staff] to be very professional, knowledgeable and responsive. They know their clients extremely well and the opinion of the staff is always highly valued when it comes to the client's health issues.”

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

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. Records showed people regularly met with their housemates and staff, with the opportunity to discuss key information, as well as their individual ambitions and goals. People could choose whether they would like to attend, and if they chose to do so, were thanked for their contribution and for participating. Meeting minutes showed a recent meeting discussed, ‘The importance of cultivating a ‘can do’ attitude and focusing on abilities rather than limitations. This mindset significantly benefits our mental health by fostering a sense of accomplishment and positivity.’ The registered manager also undertook annual quality assurance surveys with people to seek their views on whether action taken had been beneficial. For 1 person, we saw the focus on a positive atmosphere had led to them expressing they felt happier, safer and more well supported.

We saw there were also monthly meetings held between people and their designated key workers. A staff member said, “I am a key worker to 1 person. At the start of the year, I sit down with the person and support them in choosing realistic goals. Each month we break down step-by-step ways to achieve the goals. I then support [person] whilst they are achieving the goals, removing any barriers in the way and looking for risks.” We saw people had been supported to reach their goals each year. For example, 1 person had a specific goal to go to a seaside town and visit a sea life centre but preferred to go at a quieter time of year to enjoy a calmer experience. We saw the person had achieved this aim. People also discussed wider wellness goals, which included, ‘Having lunch outdoors when the weather is nice, watering the plants and helping to care for the garden, growing herbs and tomatoes and using them in home cooked meals promoting healthy eating and reducing food waste.’ We saw fruits, vegetables and herbs in a raised bed growing in the garden, which people tended to. The registered manager told us people had recently enjoyed a crumble made from fruit trees in the garden.

Staff fully involved people by ensuring information was available to them in the format they required. For example, 1 person liked to know which staff would be on shift for the week to ensure they could follow a pre-planned routine. A staff member told us, “This individual likes routine and to know which members of staff [they] have working with [them] and what [their] planned activities are for the week. We support [person] in this by having a weekly planner up in [their] room so [they] can check whenever [they] like.” There were also easily accessible guides for people which included key information such as favourite recipes, mindfulness worksheets, Easy Read information on Deprivation of Liberty Safeguards (DoLS), electoral services, fire safety, health issues, complaints and safeguarding. Easy Read is a simplified format which includes pictures and straightforward language to aid understanding. This empowered people to be listened to and involved with all areas of the service and their own care.

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

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this. A staff member told us, “Our service is really proactive in breaking down healthcare barriers for the people we support. We understand that navigating the healthcare system can be challenging for anyone, and even more so for individuals with specific needs.”

We saw the registered manager proactively advocated for people, to ensure they could access healthcare and diagnostic appointments beneficial to their needs, as any other citizen. The registered manager also worked within the local system to source specific training which would enable staff to recognise and act on any signs of deterioration in people’s needs. A professional who worked with the service told us, “[Registered manager] regularly requests training for new staff and refresher learning for existing staff, demonstrating an ongoing commitment to ensuring staff can recognise deteriorating health, respond appropriately and seek timely healthcare intervention to help avoid unnecessary hospital admissions.”

A relative said, “I have full confidence that the staff are aware of [person’s] needs and that they proactively prioritise [person’s] welfare and health needs.” A professional who worked with the service told us, “[Registered manager] in particular is always available for discussion and is always the first to advocate in a person’s best interests.” Another professional told us, “It has been a pleasure to work with this service. Staff and management are open, transparent and demonstrate a genuine commitment to achieving positive outcomes for the people they support.”

People had a hospital passport, communication passport and health action plans in place. A staff member told us, “We take the person’s ‘Hospital Passport’ with them for each appointment to show how the person likes to be cared for and any sensory impairments that may require adjustment to the service the healthcare provider offers. For example, we might request longer appointment times, quiet waiting areas, or ensure that information is presented in an accessible format.”

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. We found staff worked sensitively with people to discuss this important topic in a practical and compassionate way. People had worked with staff to create highly personalised end-of-life care plans which set out detailed information about how they would like to be cared for holistically if very unwell. People also gave their instructions about what music they would like at their funeral, what they would like to wear, what flowers they would choose and how they would like their life to be celebrated. For example, 1 person had asked for party food and balloons. Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms were in place to guide staff and healthcare professionals on people’s wishes about emergency care and treatment. Information was clearly recorded about where people’s preferred place of care would be, if they would like to go to hospital, a hospice, or remain at home and whether cardiopulmonary resuscitation (CPR) should be attempted. These plans were regularly reviewed by people with staff support to make sure there were no changes or updates they would like. The information was also provided in an Easy Read format, with pictures and simplified language to aid understanding.

Staff had provided exceptional bereavement support to people when they had lost a loved one. This included creating dedicated remembrance books with photographs and happy memories, or supporting people to create their own memorials for loved ones with flowers planted in the shared garden. Staff described supporting people to visit where their loved ones were buried, to bring fresh flowers. People also had support from religious figures if they chose to do so, for comfort when grieving. A staff member told us about how for 1 person, “A local vicar was contacted, and the person went for a prayer and lit a candle in memory, the person saw the vicar a few more times for prayers.” Another staff member told us how, “We have created a memory book for [person] with lots of lovely pictures.” The registered manager also sought specialist bereavement training for staff with the local hospice, as well as training on how to support people to age well. People themselves also took part in a training course on how to make memory boxes, for which they received certificates of achievement to recognise their contributions.