Larchfield House

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 71 (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 told us they received person-centred care in line with their needs and preferences. Their comments included, “Sure yes, I haven’t got any complaints, I’m lucky, they look after me well”, “General treatment is good, I can’t find any reason to complain”, “Very good, I can’t complain about anything really. If I need anybody, I just call and they come and sort me out” and “They’re good to me but I think they’re worked over the top, far too hard, they’re good as gold.” A relative agreed and said, “I’ve just been very impressed at how well staffed it is, how friendly, welcoming and caring.”

People were supported to take part in a range of activities of their choice. There was a team of activity coordinators providing daily activities. The home hosted a number of community events and organised visits from a range of entertainers. One person and a visiting relative recalled the pleasure they experienced when a miniature horse visited the home and visited people being cared for in bed. The home had an active social media page advertising specific larger events taking place at the home and recognising staff achievements.

We witnessed staff delivering person-centred support that met people’s needs. People’s care plans and care notes were recorded in a person-centred way.

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. However, some care plans lacked detailed information about specific health conditions.

People told us they received good care and their healthcare needs were met and relatives echoed this.

Most people’s care plans described their healthcare needs and how to meet these. For example, where a person was living with a chronic health condition, there were clear instructions for staff to follow, so they could anticipate the person becoming unwell and take appropriate action. However, the care plan of a person living with diabetes lacked detail, for example, in relation to foot care which can be an area of concern for people with this condition. We also found some minor shortfalls in relation to mental health care plans which sometimes lacked detail. There was also no specific care plan for a person whose medical condition could mean a sudden change in mental state and behaviour. This meant people’s needs might not always be met because staff may not know how to support the person appropriately. We fed this back to the provider who said they would take appropriate action without delay.

We saw evidence people were visited by healthcare professionals and supported to attend health appointments as needed. Healthcare professionals involved in people's care documented the outcome of their visits in people's records and any information or instructions for staff to follow. They included GPs, the chiropodist and speech and language team. The management and staff team had developed a good professional relationship with the local authority.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The registered manager told us they recognised the importance of effective communication. People’s communication needs were assessed during the pre-admission assessment so information could be made available to them in a format that suited them. This included larger print, pictorial aids and assistive technology. People's care plans detailed their preferences and any aids they needed to support effective communication.

People and relatives told us communication was effective, and they were provided with all the information they needed. The staff seemed to know how to communicate effectively with people. For example, one person communicated using hand gestures and using their thumb in a raised or lowered way, to indicate yes or no. At one stage in the morning they indicated that they were uncomfortable with the nearby French windows to the garden being open and wanted these shut. A carer noticed and immediately understood and responded.

Staff understood the importance of ensuring people had information that met their preferences and in a way they understood. A person whose first language was not English had difficulties expressing themselves and understanding others. We saw the staff used a translating application to help communication. The provider told us there was always a member of staff who spoke the person’s language on duty to help staff with communication. Staff offered some people a visual choice of the meal options where this would help them make an informed decision about what they wanted to eat.

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 told us they were involved in the planning of their care and support. Care plans were reviewed regularly, and people were asked for their feedback about the care they received and anything they would like to change. People and relatives told us they felt able to raise any concerns or issues and had the opportunities to attend meetings. Their comments included, “We did have a relatives’ meeting last year and they are always sending out information, forms and surveys” and “If we had a problem we would go to [Unit’s team leader].”

Staff told us they understood the importance of monitoring people’s care to help identify issues before they could develop into complaints or concerns.

Information was provided to people and their relatives about processes for sharing feedback or raising concerns. Records showed complaints received were addressed in accordance with the provider’s policies and procedures. Any learning from complaints and concerns was shared with staff to inform their future practice.

People’s needs were assessed prior to being admitted to the home, to help ensure their needs could be met. Initial assessments were clear and detailed people’s wishes and choices and how they wanted to be supported in all aspects of their daily life.

The provider made sure that people could access the care, support and treatment they needed in a timely way.

People told us they had access to the care and support they required and were happy with this. Relatives stated they felt their family members’ needs were met because the staff cared and monitored them closely.

The management team felt they were supportive in ensuring people had access to a variety of services. We saw evidence people had access to specialist care and healthcare professionals.

Care plans were regularly reviewed in order to identify any changes in a person’s care needs so the appropriate support could be found if needed. This included making appropriate referrals to external professionals as needed.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People's care and treatment promoted equality and protected people's rights. People told us they were consulted in relation to their cultural and spiritual needs. Their comments included, “I’m Church of England, the church is just over the road and I go when it’s something special” and “No thank you, I’m not a church goer and they know that.”

Staff told us they involved people in decisions about their care and respected their wishes.

The provider had an equality and diversity policy in place and was committed to creating a welcoming and inclusive atmosphere for all people and staff, regardless of sexual orientation, gender identity, or gender expression.

People’s care plans indicated they had been consulted in decision making, including whether they preferred to receive care from a male or female care worker. However, most people were unsure if they had been consulted about this. Their care plans reflected people’s physical, mental, emotional and social needs.

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.

People and their relatives were involved in the planning and reviewing of their care including their end of life wishes. Where people were not ready to discuss this area of care, their wishes had been respected and recorded.

The staff confirmed they received end of life care training and would know how to meet people’s needs when the time came.

Care plans reflected how people wanted their care to be when they reached the end of their lives. Some people were receiving end of life care at the time of our visit. Their relatives told us they were happy with the care their family members were receiving.