Housing 21 - Holm Court

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 86 (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.

The registered manager told us, “We care about each and every one of the [people using the service], we have become a family, we care about people, and support them to live best life as possible, if people need support to remain independent, we provide it.”

Records demonstrated people were consulted about the care they were provided with, and this was kept under review. This provided people with person centred care and support where their choices about how they wanted to be cared for were central to the care provision. A relative said, “When [family member] moved into Holm Court we discussed a care plan for [family member] with the assistant manager. This was updated every 6 months. I felt that the care plan met all of [family member’s] needs which of course changed over a period of time. At all times I felt that [family member] received the care, support and attention [they] needed.”

We saw several examples of how the management team had responded to how people received their care to meet their person centred needs and preferences. This included adapting, for example, times of care visits and what support people wanted, following ongoing reviews and discussions with people. For example, the registered manager and a staff member told us how the support provided to a person with their personal care was adapted to meet with the routines they had prior to starting using the service. This demonstrated the service provision was tailored to the person’s individual needs and wishes.

The electronic care planning system set out planned tasks for the care staff attending to the person’s care visits. These were developed from the care plans and decisions made by people to ensure the support they required and preferred to meet their person centred needs were delivered. Daily notes identified the care and support provided at each care visit, in addition wellbeing notes explained how the person presented, and any discussions held with the person about their care. The registered manager told us this was valuable in identifying any changes in the person’s wellbeing and were used to consider any changes needed to the care provision, with the input of people using the service.

A relative said, “All [family member’s] visits are recorded in the [electronic system] app which is a great tool as carers log what has been eaten, what meds taken, activities done etc, so we are able to reassure [family member].”Another relative said, “At the instigation of [registered manager] the introduction of the [electronic system] which was an app which gave us a great deal of information about the care [family member] was receiving was a huge bonus for us. [Family member] had reached the stage where it wasn't always easy to contact [family member] and for [family member] to tell us about life at Holm Court. This system gave us detailed information about [their] care, [their] general health and what [family member] had been doing during the day. This was something that we very much appreciated.”

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People’s care plans included information about their diverse needs, how they affected the person and how their diverse needs were being met. This included people’s health conditions, learning disability or dementia. A relative said, “[Registered manager] was excellent and constantly consulted us about what was in place and what more could be done if needed. The care plan was very clear.”

Staff had received training in people’s diverse needs, including equality and diversity, dementia, learning disability, and autism. This was important because it helped staff understand people’s individual needs and experiences, enabling them to provide care that was inclusive, respectful, and tailored to each person. For example, where a person was living with dementia, their care plan identified how this affected them and staff monitored the progression of the dementia to ensure any changes were identified. A person told us how they were supported by staff and given time to discuss their condition. This was confirmed by a relative.

The registered manager told us about the support provided to a person with a learning disability to access the local community independently, this included transport support and arranging with the local authority access to training to use public transport. In addition, a mobile telephone was provided for their birthday, when they had not had a device before. All of this had made a positive impact on the person who could go out independently with confidence. This person confirmed what we had been told and they said they were very happy using the service. They also told us they were planning to redecorate their flat. They said, “[Registered manager] and the staff have helped me a lot.”

The registered manager, staff, and people described how support helped them access the wider community and participate in local life. This included, where people wished to participate, the involvement in events at a local place of worship, and planned outings, such as a visit to a local seaside town, which reduced the risks of loneliness and isolation. A staff member told us about how they had made a bid to the provider and had been awarded a sum of money for a sensory garden. They were working with the people who used the service and a meeting was arranged with a local college to discuss what support from students could be provided to develop the garden in partnership with people using the service. The staff member said, “Lots of people living here love gardening and they are excited to get involved.”

The registered manager told us people received care from permanent care staff which ensure continuity of care. A team of bank staff had been employed to help cover visits where needed. This ensured people received care from staff who they knew and who knew them.

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

People’s care records included information about their communication needs. Where required, important information including the complaints procedure, could be provided in accessible formats, including easy read, larger print and in languages other than English. This was important because it helped ensure people could understand their rights, raise concerns if needed, and be fully involved in decisions about their care.

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.

The provider was committed to hearing and valuing people’s voices and using them to continuously improve. This included forums for people who used the service to share their views about the service and make suggestions. The provider undertook satisfaction surveys in each of their services and the responses were reviewed, analysed and feedback provided to each location, including any improvements required. At the last survey Holm Court had achieved 100% satisfaction. A further survey had been undertaken since these results were shared, the outcomes had not yet been shared. The service’s newsletters sent to people, also included a section from the provider which advised on how people could share their views, such as involvement in the forums for people using the service.

The registered manager told us about how they shared the provider’s commitment and passion for ensuring people’s comments about the service were used to improve. To support this, they undertook their own satisfaction surveys, and the registered manager told us if they had received feedback about a specific area, or a complaint, they developed a survey about that particular subject, for example, the quality of the catering provision. This supported the registered manager to identify if there was an ongoing issue which needed to be addressed before it escalated.

Monthly meetings were held which were attended by people using the service, and their relatives. The minutes of these were shared with people and included an action plan developed using people’s suggestions and updates on actions previously taken as a result of comments received. A relative told us, “I was able to attend the residents meeting held on a monthly basis so I knew of any changes and improvements that the [registered manager] was intending to make. [Registered manager] was also able to respond to queries, comments or requests at this meeting.”

‘You said we listened’ posters were displayed in the service to show what actions had been taken as a result of people’s comments and suggestions, this included pet therapy to attend the service, and spotlights and sensors installed to make people feel safe. The registered manager told us, as a result of people’s comments, a suggestion box had been put in the entrance to the service. This was regularly checked. We saw the minutes from a meeting which confirmed people had raised this, and they were updated once it was in place and people encouraged to post their suggestions.

As part of regular spot checks, people were asked for their views about care staff and their experiences of being supported by them, this was called, ‘care to share’. This feedback was used as part of the staff member’s one to one supervision.

There was a complaints procedure in place, and the registered manager told us when received these were acted on and used to improve the service. People and relatives told us they knew how to raise a concern or formal complaint, and they were confident they would be listened to.

Although people told us they had no need to make a complaint, we received feedback about the actions taken as a result of what had been said. A relative told us, “We are a family that is very involved with [family member] and if any issues or concerns, these always dealt with.” Another relative told us how they felt any queries were addressed quickly, “For example, we asked if [family member] could have [their] evening snack a bit later in the evening and this was undertaken very quickly.” Another relative said, “We were asked on many occasions and this actually led to many changes to [family member’s] care and a review of [their]care plan. We had to extend the length of one of [family member’s] visits and change the timings slightly.”

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

The registered manager explained how they had, and would continue to, advocate on people’s behalf, with their consent, when care or treatment needs were not being met. For example, concerns were reported to another service’s management team and the local authority, and the service worked closely with the person and their relatives to help reduce future risks. In addition, the registered manager told us how they had followed the provider’s unsafe discharge from hospital processes when they were concerned that a person was unwell. They had contacted the Care Quality Commission and used the systems in place to raise concerns with the appropriate professionals. These actions had led to positive outcomes for the people, and they were able to receive and access the services they required and were entitled to.

The registered manager told us how they followed the provider’s procedures for undertaking care assessments within 48 hours if a person had been admitted to hospital. This was to ensure the service could still meet the person’s needs and to reduce hospital discharge delays. The registered manager shared examples of additional support accessed, such as support for people to access local authority reablement team, if a person required additional short term support following hospital admission to allow the person to return to their home. This was important because it helped promote people’s recovery, independence, and safety, and reduced the risk of unnecessary longer‑term care or readmission to hospital.

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.

People were central to the care they received; they were involved in their needs assessments, care planning and care reviews. Their decisions and comments were valued and used to shape their individual care package. People had the opportunity to make changes to their care when they wanted, and this was listened to and acted on. The registered manager told us about the steps taken to ensure everyone using the service was treated equally.

The registered manager told us how they supported people to access services in the community, where they could not do this themselves, or did not have a representative who could support them. This included contacting health professionals on their behalf to reduce the risks of them not receiving the care and support they required. The registered manager told us they had good relationships with other professionals involved in people’s care. This was important because it supported effective communication, joined‑up working, and helped ensure people received coordinated, safe, and timely care.

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.

Discussions with the registered manager and records viewed demonstrated people’s decisions about their life changes were discussed and documented. The registered manager told us they ensured people could remain in their own home, if, for example they became unwell. If people were admitted to hospital, their needs were assessed prior to them returning to their homes. To ensure the service could still meet their needs. If additional support was required, the registered manager told us they worked with commissioners to identify other services, for example to local authority reablement team who could provide short term support until the person had fully recovered.

People’s care records included information about if they had made end of life decisions, including how they wished to be cared for and if they wished to be resuscitated. These records demonstrated meaningful and compassionate discussions had been held with people and their relatives, where appropriate, as they had included details such as the music they wished to listen to. This was important because it helped ensure people’s wishes were understood, respected, and followed, enabling care to be provided in a way that was dignified, person‑centred, and in line with what mattered most to them.

Information was included in care plans relating to people’s decisions of if they wished to remain at home if they became unwell, and important contact details of their representatives, where they had been identified as a point of contact. The registered manager told us how they had worked with the district nursing team who had supported the service in the provision of end-of-life care.

Staff received training in end-of-life care, equality and diversity and the provider’s own end of life guidance was accessible. A person’s relative said, “As a family we were very grateful to all the staff when [family member] reached the end of [their] life. The extra care and attention [family member] received in the last few days of [their] life were exemplary. The kindness and compassion shown to [family member] was second to none. This helped us during a very difficult time knowing that we had made a very good decision in arranging [family member’s] care at Holm Court.” Another relative told us, “[Registered manager] ensured, that during [family member’s] end of life [their] care was just wonderful. All of the staff were friendly and genuinely cared for the residents and [family member’s] end of life care by all demonstrated great kindness and compassion.”