Hunters Care Centre

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 service 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 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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.

In the main, care plans were detailed and described people’s choices and preferences for how they wanted staff to support them. However, one of the care plans we looked at was missing some information. For example, we looked at the plan for one person who was unable to communicate, and the care plan referred to staff checking the person’s facial expression to understand how they were feeling, but there was nothing documented to explain what this meant. In the same plan it was documented that the person had their own teeth but was reluctant to have oral care. The plan did not inform staff how to manage this. Despite this, staff we spoke with knew people well and understood their preferences and choices and how to support them to meet their needs.

The majority of people and their relatives were positive about the care and support they received from the service. Comments form people’s relatives included, “Excellent”; “Overall it’s a first rate service.” and “Excellent. I was impressed from the very first time I visited the home on reconnaissance to the current day, which is now two plus years on.”

The service had embedded the standards of the provider’s dementia care framework to support people living with dementia. They had 3 dementia champions whose role was to promote the knowledge and understanding amongst the staff team as well as supporting people’s families. They told us they embed the practice and look after people in such a way that they can live the life they want and if there was any distress or they required support, that’s when the tools came in.

The service was using the CAREFUL observations framework and the Cornell Scale for Depression in Dementia which were carried out every 3 months by trained staff. This enabled the service to recognise early signs of distress to people which could help prevent incidents and involve healthcare professional at an early stage. Alongside these tools, the champions told us they used the Five Domains of Wellbeing to learn people, so they feel safe and at home in the service.

As part of the framework standards, the Pain Assessment in Advanced Dementia Scale (PAINAD) was used to establish pain scoring for people living with dementia who may not be able to communicate their pain levels. They provided an example of how this was used for one person who was new to the service and experienced pain and frustration. They were able to ascertain where the pain was located and treat it with medicine.

Staff told us they were proud of the quality of care they provided to people living with dementia. They tried to make the environment friendly and safe as it was very important for people to feel safe. They explained that most people knew them by name, smiled when they saw them in the mornings, they were not disorientated, which to them was a good sign they were doing their job properly. The regional dementia lead told us they did not receive referrals for distressed behaviour from the service as staff were preventing these.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

There was a consistent staff team in post which supported continuity of care for people.

The provider worked with people and healthcare partners to establish continuity of care, including when people moved between different services. Staff told us how they referred people for GP review. Staff could contact the GP surgery at any time if they had any concerns or questions, alongside regular on-site visits. We saw records in place of when people were reviewed by health professionals. A staff member told us the nurse team could refer people directly for SALT and TVN advice for example.

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

There was information available around the service, for example on noticeboards, for people and relatives. Leaflets providing information related to end of life and dementia care were also made available.

The provider had an extensive bank of communication cards in different languages, which also incorporated pictures aids, that staff could use with people for whom English was not their first language.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

People, relative and menu meetings took place, and we saw minutes of these. Feedback was also sought via surveys, and we reviewed the latest results, which has also been shared with people and their relatives. There was a display of the most recent ‘you said, we did’ in the entrance to the service.

People told us they were invited to attend regular resident meetings where the heads of departments were present. People said they felt able to voice any issues during these meetings. People told us the day before our visit, there had been a meeting with the chef. One person said, “We had a meeting with the chef yesterday. People do ask for things, like smoked salmon and [chef] will do that with scrambled egg. I like red cabbage, and [chef] will put that on the menu as well."

Another person said, “At residents meeting and menu meeting, everyone is listening, and they make adjustments for us. It is excellent.”

Systems were in place for people to raise complaints and concerns and these were responded to in line with the provider’s policy. The registered manager was visible throughout the service and had an open-door policy. They told us, “I like to be visible in the home to address things before they become big.”

One person told us, “The management team goes around and ask me and other people how we feel and that is good.”

One relative said, “Raised concerns and have a good repour with the staff. Dealt with concerns, if not they have helped to make me understand why.”

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

People with protected characteristics were supported to have equitable access to services. For example, people with a disability which impacted their ability to leave the home were supported to access health services to meet their individual needs.

The premises were accessible for all. The service had wide corridors, lift access to all floors and natural light. There was vast outside space accessed from the ground floor.

One healthcare professional told us, “The fact that Hunters regularly refers residents to me for support with mobility and quality of life speaks volumes about their proactive approach. One such case involved a resident at risk of developing hand contractures. Rather than wait for a delayed referral, the team acted quickly, discussed the matter with the family, and arranged input from me. We were able to introduce a splint and rehab programme early, helping to prevent deterioration.”

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.

Staff received training in equity, diversity and human rights to help them understand equality and address discrimination.

People’s religious beliefs were recognised and acknowledged and staff supported people to access religious services. People with physical disabilities were supported to access local services and engage in their environment, such as attending activities and going for walks in the grounds. Many people told us they had chosen to move to the service because of the outdoor space.

One healthcare professional working with the service told us, “For the families of those who are unable to assimilate or articulate their thoughts due to impaired mental capacity for a variety of reasons, can rest assured that the staff who look after these clients make every effort to provide a homely, tranquil environment and treat everyone with dignity with emphasis on excellent standards of hygiene and grooming, clothes that co-ordinate, mental stimulation and activities.”
 

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.

Advanced care plans were in place, which included information such as whether people wished to go to hospital if their health deteriorated or if they preferred to remain at the service.

The service had begun the process of training and accreditation for the gold standard framework (GSF). The GSF staff training programme empowers care teams to deliver proactive, personalised, and well-coordinated care, improving communication and collaboration with the primary care team, hospital and community services. This in turn benefits people using services by reducing unplanned hospital admissions and deaths, enabling more people to live well and die where they choose. The registered manager told us, “My team is very kind and compassionate, they promote dignity and respect and that is reflected in our staff and resident surveys. People tell me staff are so kind and caring. We do palliative care as a whole home approach, supporting the person and the wider family.”

The deputy manager said, “If a person’s family live far away, we will offer the family a room to stay in. It's very important to the families that people have a comfortable peaceful death and that is what we aim to do. When a resident dies, we say our goodbyes, and we all line up by the door.”

A staff member told us, “I am very proud as I feel the home is doing very well with end of life. We are working towards the gold standard.”

At the time of our assessment, the service was not actively supporting anyone on end of life care, however we reviewed records of heartfelt compliments received by the service following supporting people and families through this difficult journey.