Cubbington Mill

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 79 (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 responded to any relevant changes in people’s needs.

Relatives described care that was personalised to their family member’s habits and personal routines. One relative told us their family member enjoyed a particular television programme and said, “Staff will go in to make sure it’s on the right channel at the time the programme is on. There are a lot of people there, so the fact they know them and do things like that is amazing. We go a lot, but we aren’t there all the time so knowing that things like that are taken care of is reassuring to us.” Another relative explained, “They are really good at asking [Name] about her preferences, and they go with what she wants.”

Staff understood the importance of providing care in a way that fitted around people’s individual needs and preferences. One staff member told us, “There are 2 types of care. One you see everything as a task. The second approach is everything you do is about the person. It’s not how much time have I got for you; it’s how much time do you need for me to help you in the way you want. It’s about the person.” Another staff member explained, “Everybody is different, there could be something that triggers them or something that brings an enormous amount of wellbeing, everyone is different. To get everyone's preferences right is really important." We were given the example of a person who had previously experienced periods of agitation and distress who was now more engaged and enjoying social activities with others. When evaluating this person’s care the registered manager had recorded, “The shift from being perceived primarily through the lens of challenging behaviours to being seen and supported as a whole person transformed their care experience.”

Care plans provided staff with the information they needed to provide personalised safe care. Staff shared information about people so any changes in their needs could be responded to quickly.

New staff received an induction when they started working at the home which included shadowing more experienced staff. This gave new staff the opportunity to meet people and develop an understanding of how people preferred their care to be provided. One staff member told us, “My induction was very good. I had the chance to meet the residents and to start to get to know them and them to know me. We started to build trust. The team guided me; they were really helpful.”

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.

People received continuity of care through a weekly ward round with a doctor and frailty nurse from the local GP practice. Processes were in place to share information about people prior to the ward round to promote co-ordinated care. A member of the clinical team supported the ward round to ensure advice and guidance was accurately recorded and actioned. A visiting healthcare professional told us, “Patients are put on to the ward round list with all their observations completed.” They went on to say, “Everything that is advised is followed, I feel happy leaving the care home knowing that patients will be well cared for in a safe setting.”

Some people chose to continue accessing advice and treatment from healthcare professionals outside Cubbington Mill. This was supported and respected.

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

People’s communication needs were assessed and planned for when they moved to the home. Care plans guided staff on how to adapt their approach so people could be given the best opportunity to understand information being shared. Any adjustments required to support people with their preferred method of communication were documented in their care plans. One relative told us following an illness, “[Name’s] talking has come on so much. I think this is because staff take the time to talk to her and get to know her. She can be very difficult to understand, but because they know her so well, they understand her just like we do. She can explain things herself, but it does take time. They give her the time she needs and that is reassuring.”

To support digital and alternative communication, people had access to wi-fi, iPads, laptops, and mobile devices, with staff support available as needed. Communication materials in braille, pictorial, or alternative languages were also available to ensure people had equitable access to information, regardless of their communication needs.

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 their relatives were encouraged to share ideas, raise concerns and provide feedback about the care they received and quality standards within the home. Regular ‘resident and family meetings’ supported open communication, leading to initiatives like the monthly residents' food committee. During these sessions, people met with the chef to share ideas, provide feedback, and participate in menu planning. One person told us, “We have residents’ meetings every month and discuss everything.” Another person explained, “I go to the monthly residents’ meetings, they are useful and they do minutes afterwards.”

The home had ‘Resident Ambassadors’ to provide others living in the home with a trusted contact point to share any worries and concerns or make suggestions about the home. One staff member explained, “They are like advocates, they talk to the manager and share any concerns.”

The provider had a complaints policy which was available to people. Staff told us they would support people if they raised any concerns with them. One member of care staff commented, “We have a complaint procedure but if the complaint was told to me and I could deal with it, I would do everything I could to make it right. If a resident has a complaint, then they may not be happy and I don’t want that. If it was something outside of my control, I would tell the nurses, and they would speak with the resident or the family.”

The provider reflected a “You Said, We Did” approach to demonstrate how feedback had led to meaningful improvements.

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

The provider used a range of screening tools to ensure people at risk of inequality due to their disabilities received the support they needed. For example, they used recognised tools to identify changes in people’s condition before they became severely unwell. They also used an observational tool to assess pain in people with advanced dementia or those unable to verbalise their needs.To support equity in access for people who were non-verbal, staff received dementia training to support them to understand and respond to non-verbal communication, including body language, and facial expressions. These tools helped staff to ensure everyone, whatever their abilities, received care and support at the point they needed it.

Where people had difficulties accessing treatment, staff supported people to ensure their needs were met. The deputy manager explained how they supported 1 person who had specific requirements around their mobility to receive dental surgery at a facility outside the home.

There was a member of the leadership team on duty each day to provide advice and support in an emergency.

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.

Relatives told us staff listened to people and took time to understand what outcomes they hoped to achieve. One relative told us their family member had expressed a wish to try and walk again. They went on to say, “We knew she wouldn’t be able to; I think the nurses thought that to. But they took their opinion out of it and listened to her. They gave her the opportunity. They arranged for a physio to come and see her. She still can’t walk but she appreciated that they didn’t tell her no. They listened and initiated her request to try.”

People living at Cubbington Mill had a range of physical needs. Care plans were developed to reflect people’s individual capabilities and what support they needed to promote their mobility and achieve positive outcomes. This included a range of equipment such as wheelchairs, standing aids and hoists to enable people to mobilise safely and access different areas in the home. A specialist chair had recently been purchased to support those people with contracted limbs to shower safely.

Where people had specific and complex health conditions, managers and clinical staff liaised with other agencies or organisations with expertise in that condition. Staff used their guidance to develop strategies tailored to people’s specific needs.

All staff received equality and diversity training as part of their induction, with refresher training to reinforce knowledge and keep their practices up to date. Staff promoted equality in social, faith and emotional outcomes by enabling people to engage in activities that were relevant and important to them. One staff member told us, “It is important to take time to learn about each resident. We are all unique and we all have individual needs so what each resident wants and needs is different. How can I help a resident if I don’t understand what is important to them? If I don’t understand their beliefs I could do something wrong which goes against what they live their life by.” A relative told us, “I wish [Name] could talk to you, she’d tell you what a difference it has made to her life by living here. The staff really take the time to get to know her. She’s gone from being very sad to just thriving.”

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.

There was a commitment in the home to ensure high standards in the delivery of end-of-life care. Managers and staff were working towards accreditation under the Gold Standards Framework (GSF). This is a national framework of tools and tasks that aims to deliver a ‘gold standard of care’ for all people nearing the end of their lives.

People were invited to discuss their wishes and preferences for the care they received in their final days, and this was recorded in an advance care plan. This included where they wanted to be cared for, what level of treatment they were happy with and what they would like to happen in an emergency. Where people wished to discuss it, there was also information about any spiritual support they wanted as they moved towards the end of their life. One relative told us when staff discussed end of life care, “We had a lot of questions, mostly about what circumstances [Name] would receive treatment and would go to hospital and what it meant if she didn’t. They were very patient and explained everything. This meant we had the information to share with [Name] to involve her in making those decisions.”

Staff reflected compassion and empathy when talking about end-of-life care at Cubbington Mill. One staff member told us, "There should be dignity in death, and it is also comfort and reassurance for their family. Relatives are often in despair and to see their family member having dignity until the last moment brings a lot of peace to everyone." Another staff member commented, “Talking about the end of life can be difficult but it is really important to know residents wishes, it may be a religious belief or part of their culture that it’s important to follow. You just have to be sensitive in your approach.”

People's significant relationships were recorded and who they wanted to be contacted if they were unwell or in the event of an emergency.